Individual provider Active NPI

Debra Lynn Carter-Barth, LICSW

  • Mental Health Counselor
  • Faribault, MN
National Provider Identifier
1790923035
Registry record updated Apr 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
17263 Issued in MN
Practice address
303 1St Ave NE
Suite 240
Faribault, MN 55021-5268
Phone
(507) 412-1468
Fax
(507) 331-8677
NPI assigned
Jan 24, 2009
Last updated
Apr 9, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 17263 MN Primary
Professional Counselor 101YP2500X 17263 MN
Group Psychotherapy Psychologist 103TP2701X 17263 MN
Clinical Social Worker 1041C0700X 17263 MN
Marriage & Family Therapist 106H00000X 17263 MN

Addresses

Primary practice location

303 1St Ave NE
Suite 240
Faribault, MN 55021-5268

Mailing address

303 1St Ave NE
Suite 240
Faribault, MN 55021-5268
Phone (507) 412-1468

Other identifiers 1

IdentifierTypeStateIssuer
1790923035MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20090608000586 MN Practitioner - Clinical Social Worker 9032269337 Practice locations: Faribault, MN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

418 Heritage PL C
Faribault, MN 55021-5457
Phone (507) 412-1468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17263MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Debra Carter-Barth Past Accepting new patients

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, 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": "1232755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270771200000",
    "number": "1790923035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 1ST AVE NE",
            "address_2": "SUITE 240",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215268",
            "telephone_number": "507-412-1468",
            "fax_number": "507-331-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 1ST AVE NE",
            "address_2": "SUITE 240",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215268",
            "telephone_number": "507-412-1468",
            "fax_number": "507-331-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER-BARTH",
        "first_name": "DEBRA",
        "middle_name": "LYNN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-24",
        "last_updated": "2010-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "17263",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "17263",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MN",
            "license": "17263",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "17263",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "17263",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790923035",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Faribault, MN

Sources for this page

Verify at the official NPI Registry.