Individual provider Active NPI

Carolyn Morris, LCSW-SASD

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1811188964
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7374 Issued in WI
Practice address
10425 W North Ave Ste 311
Milwaukee, WI 53226-2400
Phone
(414) 436-9918
NPI assigned
Aug 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Clinical Social Worker 1041C0700X 2005025411 MO
Clinical Social Worker 1041C0700X 7374 WI Primary

Addresses

Primary practice location

10425 W North Ave Ste 311
Milwaukee, WI 53226-2400

Mailing address

10425 W North Ave Ste 311
Milwaukee, WI 53226-2400
Phone (414) 436-9188

Other identifiers 1

IdentifierTypeStateIssuer
43724000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20071005000221 WI Practitioner - Clinical Social Worker 0345335311 Reassigns benefits to 2 organizations

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

Practice addresses (Care Compare)

10425 W N Ave
Suite 311
Milwaukee, WI 53226-2400
Phone (414) 436-9918

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2005025411MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Rising Wellness, LLC Multi-Specialty CurrentSince Oct 14, 2021 Accepting new patients
Red Oak Counseling, LTD. Multi-Specialty Past Accepting new patients
Lutheran Social Services of Wisconsin and Upper Michigan, Inc. Multi-Specialty Past Accepting new patients

Locations

10425 W North Ave
Ste 311
Milwaukee, WI 53226
Phone (414) 436-9918

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": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1811188964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10425 W NORTH AVE STE 311",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532262400",
            "telephone_number": "414-436-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10425 W NORTH AVE STE 311",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532262400",
            "telephone_number": "414-436-9918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "CAROLYN",
        "credential": "LCSW-SASD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2005025411",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43724000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.