Active NPI
Katherine Brown Dusenbury, LICSW
- Clinical Social Worker
- Grand Forks, ND
National Provider Identifier
1720150642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4021
- Practice address
- 2808 17TH Ave S
Grand Forks, ND 58201 - Phone
- (701) 746-8376
- Fax
- (701) 746-9872
- NPI assigned
- Nov 15, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 4021 | ND | Primary |
Addresses
Primary practice location
2808 17TH Ave S
Grand Forks, ND 58201
Mailing address
2808 17TH Ave S
Grand Forks, ND 58201-4010
Phone (701) 746-8376
Other practice location 1
151 S 4th St
Suite 401
Grand Forks, ND 58201-4715
Phone (701) 795-3000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 054519 | Medicaid | ND | |
| 027727 | Other | ND | BCBS PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070309000281 | ND | Practitioner - Clinical Social Worker | 1557464625 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Lipp Carlson Witucki and Associates LTD
Practice addresses (Care Compare)
2808 17TH Ave S
Grand Forks, ND 58201-4010
Phone (701) 746-8376
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lipp, Carlson, Witucki & Associates, LTD | Current | Accepting new patients |
Locations
2808 17th Ave S
Grand Forks, ND 58201
Phone (701) 746-8376
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": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536105600000",
"number": "1720150642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2808 17TH AVE S",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582014010",
"telephone_number": "701-746-8376",
"fax_number": "701-746-9872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2808 17TH AVE S",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "58201",
"telephone_number": "701-746-8376",
"fax_number": "701-746-9872"
}
],
"practiceLocations": [
{
"address_1": "151 S 4th St",
"address_2": "Suite 401",
"address_purpose": "LOCATION",
"city": "Grand Forks",
"state": "ND",
"postal_code": "582014715",
"country_code": "US",
"telephone_number": "701-795-3000",
"fax_number": "701-795-3050",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DUSENBURY",
"first_name": "KATHERINE",
"middle_name": "BROWN",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2018-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ND",
"license": "4021",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "054519",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "027727",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grand Forks, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.