Active NPI
Kathy Corlett Dahlk, LCSW
- Clinical Social Worker
- West Allis, WI
National Provider Identifier
1477609907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1148123
- Practice address
- 2363 S 102ND Street
Suite #203
West Allis, WI 53227 - Phone
- (414) 545-1950
- Fax
- (414) 545-4168
- NPI assigned
- Jan 26, 2007
- 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 | 1148123 | WI | Primary |
Addresses
Primary practice location
2363 S 102ND Street
Suite #203
West Allis, WI 53227
Mailing address
W62 N248 Washington Avenue
Suite #207
Cedarburg, WI 53012
Phone (262) 375-1116
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40965000 | Medicaid | WI |
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 |
|---|---|---|---|
| 1148123 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477609907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W62 N248 WASHINGTON AVENUE",
"address_2": "SUITE #207",
"city": "CEDARBURG",
"state": "WI",
"postal_code": "53012",
"telephone_number": "262-375-1116",
"fax_number": "262-375-1071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2363 S 102ND STREET",
"address_2": "SUITE #203",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "53227",
"telephone_number": "414-545-1950",
"fax_number": "414-545-4168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAHLK",
"first_name": "KATHY",
"middle_name": "CORLETT",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "1148123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40965000",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Allis, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.