Individual provider Active NPI

Loretta Mary Larkey, MSW

  • Clinical Social Worker
  • Green Bay, WI
National Provider Identifier
1467687731
Registry record updated May 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1637-123 Issued in WI
Practice address
130 E Walnut St
Green Bay, WI 54301-4239
Phone
(920) 437-8256
Fax
(920) 437-1188
NPI assigned
May 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1637-123 WI Primary

Addresses

Primary practice location

130 E Walnut St
Green Bay, WI 54301-4239

Mailing address

130 E Walnut St
Green Bay, WI 54301-4239
Phone (920) 437-8256

Other identifiers 1

IdentifierTypeStateIssuer
39605800MedicaidWI

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

LicenseStateTypeSpecialty
1637-123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1242345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242345600000",
    "number": "1467687731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E WALNUT ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014239",
            "telephone_number": "920-437-8256",
            "fax_number": "920-437-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E WALNUT ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014239",
            "telephone_number": "920-437-8256",
            "fax_number": "920-437-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARKEY",
        "first_name": "LORETTA",
        "middle_name": "MARY",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-15",
        "last_updated": "2009-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "1637-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39605800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2009; 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.