Carrie Conder, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

107 N Eddy St
South Bend, IN 46617-2920

Phone

(574) 246-1036

NPI assigned

Apr 12, 2019

Last updated

Jun 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Carrie Lynn Wine 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": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1952864126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 N MAIN ST",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465282633",
            "telephone_number": "574-350-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N EDDY ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172920",
            "telephone_number": "574-246-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDER",
        "first_name": "CARRIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "WINE",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Community Health Partners of South Bend, Inc. (Bendix Family Physicians)
• Community Transit LLC
• Concept Care at Home
• Concept Therapy Home Health LLC
• Concept Therapy Professional Corporation
• Susan Lynn Conn, NP
• Connections Counseling Services LLC
• Elizabeth Ann Conner, NP
• Monique A Conner, M.S.,CCC-SLP
• Steve Glenn Connors

• Clinical Social Worker in South Bend, IN
• Providers in South Bend, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.