Individual provider Active NPI

Carrie Dawn Couture, LSCSW

  • Clinical Social Worker
  • Wichita, KS
National Provider Identifier
1780892604
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3564 Issued in KS
Practice address
2118 N Tyler Rd
Building B Suite 100
Wichita, KS 67212-2037
Phone
(316) 779-2564
Fax
(316) 779-2564
NPI assigned
May 21, 2007
Last updated
Nov 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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 3564 KS Primary

Addresses

Primary practice location

2118 N Tyler Rd
Building B Suite 100
Wichita, KS 67212-2037

Mailing address

2118 N Tyler Rd
Building B Suite 100
Wichita, KS 67212-2037
Phone (316) 779-2564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20080819000201 KS Practitioner - Clinical Social Worker 2961577473 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2118 N Tyler Rd
Suite 100B
Wichita, KS 67212-4914
Phone (316) 779-2564

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3564KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carrie Couture Lscsw LLC Clinical CurrentSince Feb 14, 2024 Accepting new patients
Michael Baker PastSince Nov 1, 2012 Accepting new patients
Emberhope, Inc Clinical Past Accepting new patients

Locations

2118 N Tyler Rd
Bldg B
Wichita, KS 67212
Phone (316) 670-0382

2118 N Tyler Rd
Ste 100B
Wichita, KS 67212
Phone (316) 295-3730

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1780892604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118 N TYLER RD",
            "address_2": "BUILDING B SUITE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672122037",
            "telephone_number": "316-779-2564",
            "fax_number": "316-779-2564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2118 N TYLER RD",
            "address_2": "BUILDING B SUITE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672122037",
            "telephone_number": "316-779-2564",
            "fax_number": "316-779-2564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUTURE",
        "first_name": "CARRIE",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "3564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.