Carrie F Kubasta, CSAC,SW

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

15318 Issued in WI

Practice address

1095 Midway Rd
Menasha, WI 54952-1115

Phone

(920) 720-2300

Fax

(920) 720-3719

NPI assigned

May 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Carrie F Burton Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1274313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1861711533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 MIDWAY RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521115",
            "telephone_number": "920-720-3700",
            "fax_number": "920-720-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 MIDWAY RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521115",
            "telephone_number": "920-720-2300",
            "fax_number": "920-720-3719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBASTA",
        "first_name": "CARRIE",
        "middle_name": "F",
        "credential": "CSAC,SW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-20",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15318",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "8289",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "BURTON",
            "middle_name": "F",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Branden J Kooiman, APNP
• Heather Kopesky
• Lisa M. Kositzke, R.D.H.
• Bryan Eugene Krause, LCSW
• Westscot G Krieger, MD
• Casey Kufahl
• Lewis Jay Kumbier, RPH
• Jenny Lou Kuske, MASSAGE THERAPIST
• Lee A Kutchenriter, LCSW
• Taylor Lackey

• Addiction (Substance Use Disorder) Counselor in Menasha, WI
• Providers in Menasha, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.