Individual provider Active NPI

Karen Laine Brogan, MA, LCSW-R

  • Clinical Social Worker
  • Rochester, NY
National Provider Identifier
1649594375
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
73 055639 Issued in NY
Practice address
1732 South Ave
Rochester, NY 14620
Phone
(585) 461-0410
NPI assigned
Mar 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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 73 055639 NY Primary

Addresses

Primary practice location

1732 South Ave
Rochester, NY 14620

Mailing address

105 Brentwood LN
Fairport, NY 14450-2226
Phone (585) 216-5213

Other practice location 1

12 N Park St
Seneca Falls, NY 13148-1437
Phone (315) 568-9412

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
73 055639NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Seneca Ontario Community Service Past Accepting new patients

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": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1649594375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BRENTWOOD LN",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144502226",
            "telephone_number": "585-216-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1732 SOUTH AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14620",
            "telephone_number": "585-461-0410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12 N Park St",
            "address_purpose": "LOCATION",
            "city": "Seneca Falls",
            "state": "NY",
            "postal_code": "131481437",
            "country_code": "US",
            "telephone_number": "315-568-9412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROGAN",
        "first_name": "KAREN",
        "middle_name": "LAINE",
        "name_prefix": "Miss",
        "credential": "MA, LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-24",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73 055639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.