Individual provider Active NPI

Carli Klinkenberg, LMSW

  • Clinical Social Worker
  • Davenport, IA
National Provider Identifier
1508595703
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2028 E. 38TH Street
Ste 3
Davenport, IA 52807-1168
Phone
(563) 424-2016
Fax
(563) 424-2017
NPI assigned
Jun 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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 Primary

Addresses

Primary practice location

2028 E. 38TH Street
Ste 3
Davenport, IA 52807-1168

Mailing address

2028 E. 38TH Street
Ste 3
Davenport, IA 52807-1168
Phone (563) 424-2016

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
QC Counselor PLC CurrentSince Oct 13, 2024 Accepting new patients

Locations

2028 E 38th St
Ste 3
Davenport, IA 52807
Phone (563) 424-2016

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1508595703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 E. 38TH STREET",
            "address_2": "STE 3",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071168",
            "telephone_number": "563-424-2016",
            "fax_number": "563-424-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2028 E. 38TH STREET",
            "address_2": "STE 3",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071168",
            "telephone_number": "563-424-2016",
            "fax_number": "563-424-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINKENBERG",
        "first_name": "CARLI",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-06",
        "last_updated": "2024-10-10",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.