Carisa Marie Dimattina, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9609-123 Issued in WI

Practice address

9000 W Wisconsin Ave
Milwaukee, WI 53226-4874

Phone

(414) 581-4004

NPI assigned

Dec 20, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Carisa Marie Phinisee Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1003576927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-581-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMATTINA",
        "first_name": "CARISA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9609-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARISA",
            "last_name": "PHINISEE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katherine L Dillon, APNP
• Laura A Dillon, DPT
• Rachel Dillon, REGISTERED NURSE
• Ruby N Dillon, LPN
• Michael Dimarco Jr., PSY.D.
• Noa Avigal Dimbert, AUD
• Dimera House
• Stephanie Erin Dimin, PTA
• Irina Kostova Dimitrova, M.D.
• Wigo Esther Dimkpa

• Clinical Social Worker in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; 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.