Kara J Andresen

Individual provider Active NPI Clinical Social Worker · El Prado, NM

NPI 1609965714 · NPPES record last updated Jul 28, 2022

Key facts

NPI
1609965714
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
I-07060 (NM)
Practice address
4 Manzano Viejo
El Prado, NM 87529-5044
Phone
(575) 741-0472
NPI assigned
Oct 12, 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 Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4 Manzano Viejo
El Prado, NM 87529-5044
Phone (575) 741-0472

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20110125000644 NM Practitioner - Clinical Social Worker 5294914123 Reassigns benefits to 1 organization
Practice locations: Taos, NM

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
I-07060NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Lotus Healing Therapy LLC Clinical Current
since Aug 1, 2022
Accepting new patients
Stillwater Counseling LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-07060 NM Yes

Addresses

Primary practice location

4 Manzano Viejo
El Prado, NM 87529-5044

Mailing address

4 Manzano Viejo
El Prado, NM 87529-5044
Phone (575) 741-0472

Other providers in El Prado, NM

All providers in El Prado, NM · Clinical Social Worker in New Mexico

Sources for this page

Verify at the official NPI Registry.