Active NPI
Carol Meza Bakke, PHD., LMSW
- Social Worker
- Farlington, KS
National Provider Identifier
1114708708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150.111495
- Practice address
- 350 W 680TH Ave
Farlington, KS 66734-4097 - Phone
- (763) 691-5085
- NPI assigned
- Oct 10, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150.111495 | IL | Primary |
Addresses
Primary practice location
350 W 680TH Ave
Farlington, KS 66734-4097
Mailing address
350 W 680TH Ave
Farlington, KS 66734-4097
Phone (763) 691-5085
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150.111495 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696896000000",
"number": "1114708708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 W 680TH AVE",
"city": "FARLINGTON",
"state": "KS",
"postal_code": "667344097",
"telephone_number": "763-691-5085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 W 680TH AVE",
"city": "FARLINGTON",
"state": "KS",
"postal_code": "667344097",
"telephone_number": "763-691-5085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEZA BAKKE, PHD.",
"first_name": "CAROL",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-10",
"last_updated": "2023-10-10",
"certification_date": "2023-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker",
"state": "IL",
"license": "150.111495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.