Organization Active NPI

Lenny Carl LCSW, Inc

  • Clinical Social Worker
  • Elkhart, IN
National Provider Identifier
1316249436
Registry record updated Nov 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34003787A Issued in IN
Legal business name
LENNY CARL LCSW, INC
Practice address
1626 N Bay Dr
Elkhart, IN 46514-4270
Phone
(574) 262-8116
NPI assigned
Nov 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2010

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

Authorized official

Name
Lenora Jean Carl, LCSW
Title
President
Phone
(574) 262-9319

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X 34003787A IN Primary

Addresses

Primary practice location

1626 N Bay Dr
Elkhart, IN 46514-4270

Mailing address

2801 E Bristol St
Elkhart, IN 46514-4386
Phone (574) 262-9319

Other identifiers 1

IdentifierTypeStateIssuer
200251470AMedicaidIN

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290384000000",
    "number": "1316249436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 E BRISTOL ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465144386",
            "telephone_number": "574-262-9319",
            "fax_number": "574-262-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 N BAY DR",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465144270",
            "telephone_number": "574-262-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LENNY CARL LCSW, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-22",
        "last_updated": "2010-11-22",
        "status": "A",
        "authorized_official_last_name": "CARL",
        "authorized_official_first_name": "LENORA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-262-9319",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003787A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200251470A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; 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.