Individual provider Active NPI

Kristen Blikken

  • Clinical Social Worker
  • Evansville, IN
National Provider Identifier
1174297766
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007938A Issued in IN
Practice address
7300 East Indiana Street
Suite 103
Evansville, IN 47715-7448
Phone
(812) 401-8008
Fax
(812) 401-8201
NPI assigned
Aug 6, 2021
Last updated
Sep 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34007938A IN Primary

Addresses

Primary practice location

7300 East Indiana Street
Suite 103
Evansville, IN 47715-7448

Mailing address

7300 E Indiana St Ste 103
Evansville, IN 47715-7448
Phone (812) 401-8008

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1174297766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 E INDIANA ST STE 103",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477157448",
            "telephone_number": "812-401-8008",
            "fax_number": "812-401-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 EAST INDIANA STREET",
            "address_2": "SUITE 103",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477157448",
            "telephone_number": "812-401-8008",
            "fax_number": "812-401-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLIKKEN",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007938A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.