Active NPI
Carolyn Kay Haas, LMSW
- Social Worker
- South Haven, MI
National Provider Identifier
1952483927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801087741
- Practice address
- 1007 East Wells Street
South Haven, MI 49090-9612 - Phone
- (269) 637-5297
- Fax
- (269) 637-9238
- NPI assigned
- Oct 19, 2006
- 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 | 6801087741 | MI | Primary |
Addresses
Primary practice location
1007 East Wells Street
South Haven, MI 49090-9612
Mailing address
801 Hazen Street PO Box 249
Suite C
Paw Paw, MI 49079-0249
Phone (269) 657-5574
Other names 1
- Carolyn Kay Archer
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
801 Hazen St
Suite C
Paw Paw, MI 49079-2008
Phone (269) 657-5574
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801087741 | MI | MD | Social Worker |
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 and National Provider Directory roles.
-
- Psychiatry Physician
- Paw Paw, MI
- NPI 1003878554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426204800000",
"number": "1952483927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 HAZEN STREET PO BOX 249",
"address_2": "SUITE C",
"city": "PAW PAW",
"state": "MI",
"postal_code": "490790249",
"telephone_number": "269-657-5574",
"fax_number": "269-657-3474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007 EAST WELLS STREET",
"city": "SOUTH HAVEN",
"state": "MI",
"postal_code": "490909612",
"telephone_number": "269-637-5297",
"fax_number": "269-637-9238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAAS",
"first_name": "CAROLYN",
"middle_name": "KAY",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-19",
"last_updated": "2015-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801087741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CAROLYN",
"last_name": "ARCHER",
"middle_name": "KAY",
"credential": "LMSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in South Haven, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.