Active NPI
Carissa R Hodgson, LCSW
- Clinical Social Worker
- Verona, WI
National Provider Identifier
1659519452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 127312-121
- Practice address
- 267 Cross Country Rd
Verona, WI 53593-1970 - Phone
- (608) 209-3519
- NPI assigned
- Feb 2, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 127312-121 | WI | Primary |
Addresses
Primary practice location
267 Cross Country Rd
Verona, WI 53593-1970
Mailing address
267 Cross Country Rd
Verona, WI 53593-1970
Phone (608) 209-3519
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 127312-121 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644796800000",
"number": "1659519452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "267 CROSS COUNTRY RD",
"city": "VERONA",
"state": "WI",
"postal_code": "535931970",
"telephone_number": "608-209-3519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "267 CROSS COUNTRY RD",
"city": "VERONA",
"state": "WI",
"postal_code": "535931970",
"telephone_number": "608-209-3519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODGSON",
"first_name": "CARISSA",
"middle_name": "R",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-02",
"last_updated": "2022-02-14",
"certification_date": "2022-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "127312-121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Verona, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.