Individual provider Active NPI

Kristy Whitaker, LCSW

  • Clinical Social Worker
  • Sylva, NC
National Provider Identifier
1962702886
Registry record updated Nov 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C007063 Issued in NC
Practice address
44 Bonnie LN
Sylva, NC 28779-8511
Phone
(828) 631-3973
Fax
(828) 631-9280
NPI assigned
Oct 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1594 NC
Clinical Social Worker 1041C0700X C007063 NC Primary

Addresses

Primary practice location

44 Bonnie LN
Sylva, NC 28779-8511

Mailing address

PO Box 2187
Sylva, NC 28779-2187
Phone (828) 631-3973

Other practice location 1

154 Medical Park Loop
Sylva, NC 28779-5271
Phone (828) 631-3973

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C007063NCMDClinical Social Worker
1594NCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Indian Hospital Authority Addiction (Substance Use Disorder) Past Accepting new patients
Cherokee Indian Hospital Authority Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1962702886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2187",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287792187",
            "telephone_number": "828-631-3973",
            "fax_number": "828-631-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 BONNIE LN",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287798511",
            "telephone_number": "828-631-3973",
            "fax_number": "828-631-9280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "154 Medical Park Loop",
            "address_purpose": "LOCATION",
            "city": "Sylva",
            "state": "NC",
            "postal_code": "287795271",
            "country_code": "US",
            "telephone_number": "828-631-3973",
            "fax_number": "828-631-9280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "KRISTY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-26",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1594",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylva, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.