Carly L Kabitz, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

28964 Issued in MN

Practice address

2308 Auerbach St
Roseville, MN 55113-4724

Phone

(651) 300-9897

NPI assigned

Nov 21, 2022

Last updated

Nov 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1629787478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 AUERBACH ST",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134724",
            "telephone_number": "651-300-9897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 AUERBACH ST",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134724",
            "telephone_number": "651-300-9897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABITZ",
        "first_name": "CARLY",
        "middle_name": "L",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "28964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Roseville, MN
• Providers in Roseville, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.