Carina Barker Clinical Practice LLC
Organization Active NPI Clinical Social Worker · Superior, WI
NPI 1174197909 · NPPES record last updated Aug 23, 2024
Key facts
- NPI
- 1174197909
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- CARINA BARKER CLINICAL PRACTICE LLC
- Practice address
- 2207 E 5TH Avenue
Superior, WI 54880 - Phone
- (218) 590-0620
- NPI assigned
- May 17, 2021
- Organization subpart
- No
Authorized official
- Name
- Carina L Barker
- Title
- Owner
- Phone
- (218) 590-0620
Practitioners 2
-
Jennifer L Hodgson, M.ED., LPC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211201000181 | WI | Part B Supplier - Clinic/Group Practice | 4880084102 |
Receives reassigned benefits from 2 practitioners Practice locations: Superior, WI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | |||
| Clinical Social Worker |
1041C0700X | Yes |
Addresses
Primary practice location
2207 E 5TH Avenue
Superior, WI 54880
Mailing address
1727 Logan Ave
Superior, WI 54880-2316
Phone (218) 590-0620
Other providers in Superior, WI
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- Carl Jeffrey Eliason
- Julie Ann Carlson
- Janice E Carter
- Caitlin Joy Caturia
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All providers in Superior, WI · Clinical Social Worker in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.