Karen A Mahan, LCSW MSW 4346123

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-10194 Issued in NM

Practice address

153 Barnard Rd
Corrales, NM 87048-6501

Phone

(262) 490-5465

Fax

(505) 899-1576

NPI assigned

Jan 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WI, NM2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Social Worker

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Trillium Care Group LLC

  • Psychologist
  • Elm Grove, WI
  • NPI 1477629640

  Clinical

  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1053461079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 BARNARD RD",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870486501",
            "telephone_number": "262-490-5465",
            "fax_number": "505-899-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 BARNARD RD",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870486501",
            "telephone_number": "262-490-5465",
            "fax_number": "505-899-1576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "KAREN",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW MSW 4346123",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "4346123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-10194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43585500",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "4346123",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joan P Lewis, MD
• Vincent John Losack, LMT
• Loving Hands Supportive Living, LLC
• Markus Maceo Sr., INTERN
• Wayne Rowan Maes, PH.D.
• Donalita Grace Maloney, PH.D.
• Nicole Danielle Mansour, FNP-BC
• Carmen Martinez Tittmann, MA LPCC LMSW
• Kaitlyn J Martinez
• Mary Hobbs Psychotherapy LLC

• Clinical Social Worker in Corrales, NM
• Providers in Corrales, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.