Active NPI
Karen Marie Duczyminski, MSW
- Clinical Social Worker
- Traverse City, MI
National Provider Identifier
1417035882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801088053
- Practice address
- 105 Hall St
Traverse City, MI 49684-2288 - Phone
- (231) 922-4850
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801088053 | MI | Primary |
Addresses
Primary practice location
105 Hall St
Traverse City, MI 49684-2288
Mailing address
105 Hall St
Traverse City, MI 49684-2288
Phone (231) 922-4850
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1708146 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801088053 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1417035882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 HALL ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842288",
"telephone_number": "231-922-4850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 HALL ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842288",
"telephone_number": "231-922-4850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUCZYMINSKI",
"first_name": "KAREN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801088053",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1708146",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.