Individual provider Active NPI

Karen Jean Dude, LICSW

  • Clinical Social Worker
  • Haverhill, MA
National Provider Identifier
1669579041
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113597 Issued in MA
Practice address
60 Merrimack St
Haverhill, MA 01830
Phone
(978) 373-1126
Fax
(978) 373-6363
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 113597 MA Primary

Addresses

Primary practice location

60 Merrimack St
Haverhill, MA 01830

Mailing address

229 Old Street Rd
Peterborough, NH 03458
Phone (603) 801-7737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20061109000287 MA Practitioner - Clinical Social Worker 5496752289 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Luk Crisis Center IncGroup PAC ID 2264476993, 6 clinicians

Practice addresses (Care Compare)

545 Westminster St
Fitchburg, MA 01420-4766
Phone (978) 345-0685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Luk Crisis Center Inc. CurrentSince Jan 5, 2019 Accepting new patients
Northeast Behavioral Health Corporation CurrentSince May 31, 2006 Accepting new patients

Locations

199 Rosewood Dr
Ste 250
Danvers, MA 01923
Phone (978) 867-7756

545 Westminster St
Fitchburg, MA 01420
Phone (978) 345-0685

60 Merrimack St
Haverhill, MA 01830
Phone (978) 373-1126

12 Methuen St
Ste 3
Lawrence, MA 01840
Phone (978) 683-3128

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/luk/r4/

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669579041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 OLD STREET RD",
            "city": "PETERBOROUGH",
            "state": "NH",
            "postal_code": "03458",
            "telephone_number": "603-801-7737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MERRIMACK ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "01830",
            "telephone_number": "978-373-1126",
            "fax_number": "978-373-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDE",
        "first_name": "KAREN",
        "middle_name": "JEAN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverhill, MA

Sources for this page

Verify at the official NPI Registry.