Karen D. Dwyer, LISW
Individual provider Active NPI Clinical Social Worker · Carson, NM
NPI 1245387893 · NPPES record last updated Dec 28, 2017
Key facts
- NPI
- 1245387893
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 1-4430 (NM)
- Practice address
- 425 So Carson Rd
Carson, NM 87517-0095 - Phone
- (575) 770-6396
- Fax
- (575) 376-7177
- NPI assigned
- Jan 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-4430 | NM | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1-4430 | NM | Yes |
Addresses
Primary practice location
425 So Carson Rd
Carson, NM 87517-0095
Mailing address
PO Box 95
Carson, NM 87517-0095
Phone (575) 770-6396
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NM 100311 | Medicaid | NM |
Other names
- Ms. Karen Pendletton Dwyer
Other providers in Carson, NM
All providers in Carson, NM · Clinical Social Worker in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 28, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.