Carolyn Disch, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

18282 Issued in MN

Practice address

7400 Metro Blvd Ste 211
Edina, MN 55439-2321

Phone

(952) 835-1616

Fax

(833) 859-1211

NPI assigned

Apr 1, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Carolyn Disch LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, MN
  • NPI 1366149775
  NPD Authorized official
• Evolving Woman Enterprises, Inc.

  • Clinical Social Worker
  • Edina, MN
  • NPI 1013099191
  NPD

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1649910985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 WILLSON RD STE 290",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241346",
            "telephone_number": "612-325-6904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 METRO BLVD STE 211",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392321",
            "telephone_number": "952-835-1616",
            "fax_number": "833-859-1211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8120 Penn Ave S Ste 500F",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "MN",
            "postal_code": "554311367",
            "country_code": "US",
            "telephone_number": "612-325-6904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DISCH",
        "first_name": "CAROLYN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-01",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "18282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ECC@edinacounselingcenter.com",
            "affiliation": "Y",
            "endpointDescription": "secure email",
            "affiliationName": "Evolving Woman Enterprises, Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "8338591211",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "secure email",
            "address_1": "7400 Metro Blvd Ste 211",
            "city": "Edina",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554392321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Discover Life Chiropractic, LLC
• Nicole M Dishong, CNM
• Steven Mark Dittes, M.D.
• Diversity Healthcare LLC

• Clinical Social Worker in Edina, MN
• Providers in Edina, 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 Jan 10, 2023; 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.