Individual provider Active NPI

Karen Estelle Wasserman, LCSW

  • Clinical Social Worker
  • Palm Beach Gardens, FL
National Provider Identifier
1750534046
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6232 Issued in FL
Practice address
219 Fortuna Dr
Palm Beach Gardens, FL 33410-4317
Phone
(561) 236-4166
NPI assigned
Oct 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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 6232 FL Primary

Addresses

Primary practice location

219 Fortuna Dr
Palm Beach Gardens, FL 33410-4317

Mailing address

219 Fortuna Dr
Palm Beach Gardens, FL 33410-4317
Phone (561) 236-4166

Other practice location 1

4384 Purdy Ln
Palm Springs, FL 33406-7562
Phone (786) 942-0502

Other practice location 2

560 Village Blvd Ste 325A
West Palm Beach, FL 33409-1945
Phone (954) 224-0555

Other identifiers 1

IdentifierTypeStateIssuer
6232OtherFLFLORIDA LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190924001916 FL Practitioner - Clinical Social Worker 9436489085 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6232FLMDClinical Social Worker

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": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1750534046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 FORTUNA DR",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104317",
            "telephone_number": "561-236-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 FORTUNA DR",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104317",
            "telephone_number": "561-236-4166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4384 Purdy Ln",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "FL",
            "postal_code": "334067562",
            "country_code": "US",
            "telephone_number": "786-942-0502",
            "fax_number": "786-999-0712",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "560 Village Blvd Ste 325A",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334091945",
            "country_code": "US",
            "telephone_number": "954-224-0555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "KAREN",
        "middle_name": "ESTELLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-30",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "6232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE NUMBER",
            "identifier": "6232",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

Verify at the official NPI Registry.