Carol R McKibben, MSW

Primary specialty

CounselorTaxonomy code 101Y00000X

License

CSWA A3182 Issued in OR

Practice address

621 W. Madrone St
Roseburg, OR 97470-3090

Phone

(541) 440-3532

Fax

(541) 440-3554

NPI assigned

Jan 12, 2007

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 identifiers 1

Other names 1

• Mrs. Carol R Stice Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395964800000",
    "number": "1932250560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 W. MADRONE ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703090",
            "telephone_number": "541-440-3532",
            "fax_number": "541-440-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W. MADRONE ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703090",
            "telephone_number": "541-440-3532",
            "fax_number": "541-440-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKIBBEN",
        "first_name": "CAROL",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2014-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "CSWA A3182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500660589",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "STICE",
            "middle_name": "R",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shaun McGowan, PA-C
• Carlynn McInerny, NP
• Anita Ruth McIntyre, RN, IBCLC
• Bre Anna Marie McKamey
• Anisa M McKenzie
• Danielle Marie McKiddy
• Susan Michele McLaughlin, BS
• Daniel B McMaster, DMD
• Jennifer McMullin
• Brady Thomas McNulty, PHARMD

• Counselor in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2014; 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.