Individual provider Active NPI

Karen M Dague, LCSW-R

  • Clinical Social Worker
  • Norwich, NY
National Provider Identifier
1700830346
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R049829 Issued in NY
Practice address
5 Court Street
Ste 42
Norwich, NY 13815
Phone
(607) 337-1600
Fax
(607) 334-4519
NPI assigned
May 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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 R049829 NY Primary

Addresses

Primary practice location

5 Court Street
Ste 42
Norwich, NY 13815

Mailing address

5 Court Street
Ste 42
Norwich, NY 13815
Phone (607) 337-1600

Other identifiers 1

IdentifierTypeStateIssuer
01682659MedicaidNY

Other names 1

  • Karen M Yacano Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20070927000445 NY Practitioner - Clinical Social Worker 6406941012 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R049829NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Chenango CurrentSince Dec 12, 2024 Accepting new patients
Chenango County County Treasurer CurrentSince Dec 12, 2024 Accepting new patients
Behavioral Health Services North, Inc. PastSince Apr 19, 2020 Accepting new patients
Behavioral Health Services North, Inc. PastSince Apr 28, 2024 Accepting new patients

Locations

5 Court St
Ste 42
Norwich, NY 13815
Phone (607) 337-1600

Interoperability endpoints

  • Direct secure messaging: kdague@ccbhs.medentdirect.com

Organizations & group practices 4

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1700830346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 COURT STREET",
            "address_2": "STE 42",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "13815",
            "telephone_number": "607-337-1600",
            "fax_number": "607-334-4519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 COURT STREET",
            "address_2": "STE 42",
            "city": "NORWICH",
            "state": "NY",
            "postal_code": "13815",
            "telephone_number": "607-337-1600",
            "fax_number": "607-334-4519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGUE",
        "first_name": "KAREN",
        "middle_name": "M",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2024-12-20",
        "certification_date": "2022-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R049829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01682659",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "YACANO",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norwich, NY

Sources for this page

Verify at the official NPI Registry.