NPIMap

Organization Active NPI

Mulberry Center, Inc.

  • Clinical Social Worker
  • Evansville, IN
National Provider Identifier
1407919848
Registry record updated Apr 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MULBERRY CENTER, INC.
Practice address
414 SE 4TH St
Evansville, IN 47713-1206
Phone
(812) 423-4700
Fax
(812) 421-2618
NPI assigned
Dec 18, 2006
Last updated
Apr 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2014

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

Authorized official

Name
Mr. Michael Carroll
Title
Acting Exec Director
Phone
(812) 436-4231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

414 SE 4TH St
Evansville, IN 47713-1206

Mailing address

414 SE 4TH St
Evansville, IN 47713-1206
Phone (812) 423-4700

Other identifiers 2

IdentifierTypeStateIssuer
200453230AMedicaidIN
200453230MedicaidIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396310400000",
    "number": "1407919848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 SE 4TH ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131206",
            "telephone_number": "812-423-4700",
            "fax_number": "812-421-2618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 SE 4TH ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131206",
            "telephone_number": "812-423-4700",
            "fax_number": "812-421-2618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULBERRY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2014-04-01",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ACTING EXEC DIRECTOR",
        "authorized_official_telephone_number": "812-436-4231",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200453230A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200453230",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; 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.