Individual provider Active NPI

Karen Sue Sifuentes

  • Clinical Social Worker
  • North Las Vegas, NV
National Provider Identifier
1205117272
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2412 Elmont Ave
North Las Vegas, NV 89086-1556
Phone
(916) 485-6500
NPI assigned
Sep 6, 2011
Last updated
Jun 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 34543 CA
Clinical Social Worker 1041C0700X 76306 CA
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

2412 Elmont Ave
North Las Vegas, NV 89086-1556

Mailing address

2412 Elmont Ave
North Las Vegas, NV 89086-1556
Phone (916) 904-0062

Other identifiers 1

IdentifierTypeStateIssuer
1275756322MedicaidCA

Other names 1

  • Ms. Karen Sue Merson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20180419001882 CA Practitioner - Clinical Social Worker 9133482425 Practice locations: Roseville, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
James Meyer Social Worker PastSince Apr 9, 2018 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1205117272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 ELMONT AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890861556",
            "telephone_number": "916-904-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 ELMONT AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890861556",
            "telephone_number": "916-485-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIFUENTES",
        "first_name": "KAREN",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-06",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "34543",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "76306",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275756322",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "MERSON",
            "middle_name": "SUE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.