Carol Grace Trout, LCSW 7269123

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7269123 Issued in WI

Practice address

3900 W Brown Deer Rd
Suite 200
Brown Deer, WI 53209

Phone

(414) 540-2170

Fax

(414) 540-2171

NPI assigned

Nov 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carol Grace Muryn Other name

Medicare fee-for-service enrollment

Enrolled in WI

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

Specialty

Clinical Social Worker

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Psychology Associates, Inc.Group PAC ID 9133114333, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Medical Psychology Associates, Inc.

  • Adult Mental Health Clinic/Center
  • Glendale, WI
  • NPI 1043307598
  Medicare reassignment Care Compare group NPD
• Compassion Psychotherapy Center LLC

  • Clinical Social Worker
  • Glendale, WI
  • NPI 1023823317
  NPD Authorized official

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649359308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 W BROWN DEER RD",
            "address_2": "SUITE 200",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "53209",
            "telephone_number": "414-540-2170",
            "fax_number": "414-540-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 W BROWN DEER RD",
            "address_2": "SUITE 200",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "53209",
            "telephone_number": "414-540-2170",
            "fax_number": "414-540-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROUT",
        "first_name": "CAROL",
        "middle_name": "GRACE",
        "credential": "LCSW 7269123",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7269123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41003500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "MURYN",
            "middle_name": "GRACE",
            "credential": "APSW 1866121",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Victoria Vandoren
• Village Dental LLC
• Alyssa C Vosters, M.A. MFT

• Clinical Social Worker in Brown Deer, WI
• Providers in Brown Deer, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.