Michael John Carle, MSSW LICSW
Individual provider Active NPI Social Worker · Otsego, MN
NPI 1366476277 · NPPES record last updated Jun 17, 2008
Key facts
- NPI
- 1366476277
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 7229 (MN)
- Practice address
- 9075 Quaday Ave NE
Suite 102
Otsego, MN 55330-6672 - Phone
- (763) 746-9492
- Fax
- (763) 746-3685
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Support Services Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 7229 | MN | Yes |
Addresses
Primary practice location
9075 Quaday Ave NE
Suite 102
Otsego, MN 55330-6672
Mailing address
1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1786
Phone (651) 628-9566
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 536557100 | Medicaid | MN |
Other providers in Otsego, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2008. 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.