Active NPI
Laurie A Licari, L.I.S.W.
- Social Worker
- Council Bluffs, IA
National Provider Identifier
1942490461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 06607
- Practice address
- 710 Willow Ave
Council Bluffs, IA 51501-4109 - Phone
- (712) 254-9018
- Fax
- (712) 256-5715
- NPI assigned
- Jul 31, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 06607 | IA | Primary |
Addresses
Primary practice location
710 Willow Ave
Council Bluffs, IA 51501-4109
Mailing address
101 E 22ND St
Atlantic, IA 50022-2800
Phone (712) 254-9018
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06607 | IA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410912000000",
"number": "1942490461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 E 22ND ST",
"city": "ATLANTIC",
"state": "IA",
"postal_code": "500222800",
"telephone_number": "712-254-9018",
"fax_number": "712-254-9019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 WILLOW AVE",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515014109",
"telephone_number": "712-254-9018",
"fax_number": "712-256-5715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICARI",
"first_name": "LAURIE",
"middle_name": "A",
"credential": "L.I.S.W.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-31",
"last_updated": "2014-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IA",
"license": "06607",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.