Carol M Allan, MSW, LCSW, DCSW

Individual provider Active NPI Clinical Social Worker · Brookfield, WI

NPI 1477650604 · NPPES record last updated Apr 23, 2008

Key facts

NPI
1477650604
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
963123 (WI)
Practice address
675 N Brookfield Rd Ste 103
Suburban Counseling Services
Brookfield, WI 53045-5858
Phone
(262) 391-4892
Fax
(262) 789-8759
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
963123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Counseling Services LLC Past
since Oct 12, 2001
Accepting new patients
Suburban Counseling Services Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 963123 WI Yes

Addresses

Primary practice location

675 N Brookfield Rd Ste 103
Suburban Counseling Services
Brookfield, WI 53045-5858

Mailing address

675 N Brookfield Rd Ste 103
Suburban Counseling Services
Brookfield, WI 53045-5858
Phone (262) 391-4892

Other identifiers

IdentifierTypeStateIssuer
000044386OtherWIMEDICARE PROVIDER ID#:

Other providers in Brookfield, WI

All providers in Brookfield, WI · Clinical Social Worker in Wisconsin

Sources for this page

Verify at the official NPI Registry.