Carrie B Ison, LCSW,SAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8579-123 Issued in WI

Practice address

301 E Saint Joseph St
Green Bay, WI 54301-2241

Phone

(920) 433-3630

Fax

(920) 437-0533

NPI assigned

Feb 25, 2014

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 names 1

• Carrie B Krajewski Former name

Medicare fee-for-service enrollment

Enrolled in WI

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spectrum Behavioral Health LLCGroup PAC ID 2961713359, 2 clinicians

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.

• Spectrum Behavioral Health LLC

  • Community/Behavioral Health Agency
  • Green Bay, WI
  • NPI 1053718890
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1083039259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22040",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052040",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E SAINT JOSEPH ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012241",
            "telephone_number": "920-433-3630",
            "fax_number": "920-437-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISON",
        "first_name": "CARRIE",
        "middle_name": "B",
        "credential": "LCSW,SAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-25",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "18174-130",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8579-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "KRAJEWSKI",
            "middle_name": "B",
            "credential": "LCSW,SAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Interim Healthcare of N E Wi Inc
• Interim Healthcare Staffing Services Inc
• Steven Ippolito, MD
• Nicole M Isham, R.D., C.D.
• Abadir M Ismail
• Kendra Ison, OT
• Michael W. Itagaki, MD
• Janelle Michelle Iwen, PHARMD
• Hussam Jaber
• Sarah Lynn Jabo, PA-C

• 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 Sep 16, 2019; 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.