Active NPI
Carly Ann Klenklen, LMSW
- Social Worker
- Iola, KS
National Provider Identifier
1134812365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 13123
- Practice address
- 304 N Jefferson Ave
Iola, KS 66749-2327 - Phone
- (620) 365-5717
- NPI assigned
- Jun 1, 2023
- Last updated
- Jun 13, 2023
- Sex
- Female
- Sole proprietor
- No
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 | 13123 | KS | Primary |
Addresses
Primary practice location
304 N Jefferson Ave
Iola, KS 66749-2327
Mailing address
525 N Grant St
Erie, KS 66733-1007
Phone (620) 212-0574
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 |
|---|---|---|---|
| 13123 | KS | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686614400000",
"number": "1134812365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 N GRANT ST",
"city": "ERIE",
"state": "KS",
"postal_code": "667331007",
"telephone_number": "620-212-0574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 N JEFFERSON AVE",
"city": "IOLA",
"state": "KS",
"postal_code": "667492327",
"telephone_number": "620-365-5717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLENKLEN",
"first_name": "CARLY",
"middle_name": "ANN",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-01",
"last_updated": "2023-06-13",
"certification_date": "2023-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "KS",
"license": "13123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Iola, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.