Individual provider Active NPI

Karen Marie Stenstrom, LCSW

  • Clinical Social Worker
  • Evansville, IN
National Provider Identifier
1487306825
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34004100A Issued in IN
Practice address
7409 Eagle Crest Blvd Ste G
Evansville, IN 47715-9136
Phone
(812) 842-4020
Fax
(812) 842-4019
NPI assigned
Jan 26, 2022
Last updated
Jan 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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 34004100A IN Primary

Addresses

Primary practice location

7409 Eagle Crest Blvd Ste G
Evansville, IN 47715-9136

Mailing address

PO Box 637273
Cincinnati, OH 45263-7273
Phone (812) 842-4200

Other identifiers 1

IdentifierTypeStateIssuer
34004100AOtherININ STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220208000421 IN Practitioner - Clinical Social Worker 4284027681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7409 Eagle Crest Blvd G
Wellness and Counseling Services
Evansville, IN 47715-9136
Phone (812) 842-4020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34004100AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Women's Hospital of Southern Indiana, LLC Clinical CurrentSince Mar 7, 2022 Accepting new patients
Deaconess Women's Hospital of Southern Indiana, LLC Current Accepting new patients
Deaconess Women's Hospital of Southern Indiana, LLC Clinical CurrentSince Mar 7, 2022 Accepting new patients

Locations

7409 Eagle Crest Blvd
Ste G
Evansville, IN 47715
Phone (812) 774-8919

4199 Gateway Blvd
Newburgh, IN 47630
Phone (812) 842-4200

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1487306825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637273",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452637273",
            "telephone_number": "812-842-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7409 EAGLE CREST BLVD STE G",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477159136",
            "telephone_number": "812-842-4020",
            "fax_number": "812-842-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STENSTROM",
        "first_name": "KAREN",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004100A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN STATE LICENSE",
            "identifier": "34004100A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.