Kristin A Dorn, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

9147-123 Issued in WI

Practice address

444 N Westhill Blvd
Appleton, WI 54914-5715

Phone

(920) 750-7000

Fax

(920) 364-2451

NPI assigned

Sep 11, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kristin Roovers Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1306365408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 N WESTHILL BLVD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549145715",
            "telephone_number": "920-750-7000",
            "fax_number": "920-364-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N WESTHILL BLVD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549145715",
            "telephone_number": "920-750-7000",
            "fax_number": "920-364-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORN",
        "first_name": "KRISTIN",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-11",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "9147-123",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "129420-121",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100071285",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "ROOVERS",
            "credential": "APSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jane E. Doolan, MS, LPC
• Morgan R Dopp, DPT
• Sara N Doran, CCC-SLP
• Shae A Doran, D.C., CACCP
• Marialyce Brennan Dorman, LMT
• Brianna L Dostalek, PA
• Wendi A Doszak, COTA
• Sarah M Dotterweich, PTA
• James J Doty I, D.P.M.
• Kayla Doucette, MS SLP-CCC

• Social Worker in Appleton, WI
• Providers in Appleton, WI by specialty
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; 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.