Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Khannah Keziah Wetmore, LISW-S

Individual provider Clinical Social Worker · NPI 1629754122

Khannah Keziah Wetmore, LISW-S is a Clinical Social Worker in Beachwood, Ohio. Qualified in 2019, 7 years ago. Practices with Psychological and Behavioral Consultants LLC, a 577-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Ohio.

Years since qualifying
7
Licensed in
OH
In the registry since
2023
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Practice location Address checks out

23625 Commerce Park Ste 100
Beachwood, OH 44122-5847
Phone: (216) 468-5000
Fax: (216) 831-4410
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 300 E 185th St, Cleveland, OH 44119-1330 — (216) 383-2222

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence I.2204081-SUPV (OH)

Record details

NPI number1629754122
Entity typeIndividual (Type 1)
GenderFemale
Credentials LISW-S
Sole proprietorNo
NPI enumeratedJune 27, 2023
Last updated in NPPESApril 23, 2026
Certification dateApril 23, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Psychological And Behavioral Consultants Llc — 577 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Beachwood