Carrie A Liu, CSAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

17027-132 Issued in WI

Practice address

4109 67TH St
Kenosha, WI 53142-3836

Phone

(262) 652-9830

Fax

(262) 652-2931

NPI assigned

May 9, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Carrie Rudd Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Oakwood Clinical Associates, LTD

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kenosha, WI
  • NPI 1447289434

  Addiction (Substance Use Disorder)

  NPD
• Racine County Finance Department

  • Community/Behavioral Health Agency
  • Racine, WI
  • NPI 1144412305
  NPD (past)

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1346986759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 67TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423836",
            "telephone_number": "262-652-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 67TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531423836",
            "telephone_number": "262-652-9830",
            "fax_number": "262-652-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "CARRIE",
        "middle_name": "A",
        "credential": "CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-09",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17027-132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "RUDD",
            "credential": "CSAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John M Lindell, DDS
• Kelly Lindenbaum
• Kristin Lindstrom
• Florisa Lingad
• Lipid Specialists, S.C.
• Terry C. Liu, M.D.
• Livingwell Home Medical Supplies Inc
• Livingwell N-Home Therapy LLC
• Livito LLC
• LJH Ambulance, Inc

• Addiction (Substance Use Disorder) Counselor in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.