Active NPI
Elaine Marie Kersten, LCSW LMFT
- Social Worker
- Watertown, WI
National Provider Identifier
1962489450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 3764123
- Practice address
- 129 Hospital Dr
Watertown, WI 53098-3384 - Phone
- (920) 262-4800
- Fax
- (920) 262-4813
- NPI assigned
- Dec 27, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 3764123 | WI | Primary |
| Marriage & Family Therapist | 106H00000X | 358-124 | WI |
Addresses
Primary practice location
129 Hospital Dr
Watertown, WI 53098-3384
Mailing address
129 Hospital Dr
Watertown, WI 53098-3384
Phone (920) 262-4800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43572400 | Medicaid | WI |
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 |
|---|---|---|---|
| 3764123 | WI | MD | Social Worker |
| 358-124 | WI | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443398400000",
"number": "1962489450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 HOSPITAL DR",
"city": "WATERTOWN",
"state": "WI",
"postal_code": "530983384",
"telephone_number": "920-262-4800",
"fax_number": "920-262-4813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 HOSPITAL DR",
"city": "WATERTOWN",
"state": "WI",
"postal_code": "530983384",
"telephone_number": "920-262-4800",
"fax_number": "920-262-4813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERSTEN",
"first_name": "ELAINE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LCSW LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-27",
"last_updated": "2015-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "3764123",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WI",
"license": "358-124",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43572400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Watertown, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.