Cory Michael Carline, EDD, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12468-123 Issued in WI

Practice address

2676 Trojan Dr Apt G16
Green Bay, WI 54304-1260

Phone

(920) 664-3178

NPI assigned

Apr 28, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Edges Wellness Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
  • NPI 1306389861

  Clinical

  Medicare reassignment NPD
• Oneida Nation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1205825130
  NPD (past)

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

{
    "created_epoch": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1073201935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2676 TROJAN DR APT G16",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543041260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2676 TROJAN DR APT G16",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543041260",
            "telephone_number": "920-664-3178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "390 Red Cedar St Ste 108",
            "address_purpose": "LOCATION",
            "city": "Menomonie",
            "state": "WI",
            "postal_code": "547512265",
            "country_code": "US",
            "telephone_number": "612-217-0584",
            "fax_number": "888-778-2961",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "730 E 38th St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554075218",
            "country_code": "US",
            "telephone_number": "612-217-0584",
            "fax_number": "888-778-2961",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLINE",
        "first_name": "CORY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "EDD, MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-28",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "12468-123",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "35505",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "131470-121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Meier Carli, O.D.
• Glenn David Carli, O.D.
• John Carli, OD
• Joshua D Carli, OD
• Lynn Marie Carli, OD
• Derek Carl Carlson, MD
• Kavita Carlson, LCSW
• Lauryn Carlson
• Caitlin M Carmody, MS
• Linda A Carmody, Ms, LPC

• Clinical Social Worker in Green Bay, WI
• Providers in Green Bay, 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 Mar 4, 2026; 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.