Carolyn N Ketchel, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW4709 Issued in FL

Practice address

151 Mary Esther Blvd
Suite 302
Mary Esther, FL 32569-1972

Phone

(850) 243-1302

Fax

(850) 301-0671

NPI assigned

Dec 15, 2011

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 identifiers 1

Other names 1

• Carolyn N Kethcel Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1323907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392163200000",
    "number": "1972872216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7",
            "city": "SHALIMAR",
            "state": "FL",
            "postal_code": "325790007",
            "telephone_number": "850-243-1302",
            "fax_number": "850-301-0671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MARY ESTHER BLVD",
            "address_2": "SUITE 302",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325691972",
            "telephone_number": "850-243-1302",
            "fax_number": "850-301-0671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHEL",
        "first_name": "CAROLYN",
        "middle_name": "N",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-15",
        "last_updated": "2014-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW4709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIENSE",
            "identifier": "SW 4709",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "KETHCEL",
            "middle_name": "N",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jania Johnson
• Maren Isabella Jones
• Joseph P Skelly, P.a.
• K. Douglas Bowers, DDS, PA
• Alexa Eve Kadletz
• Tara Kirby, LMHC
• Bonnie Jean Knox, CRNA
• Notlie C Lammie
• Brittany Lane
• Larhonda Michelle Lang

• Clinical Social Worker in Mary Esther, FL
• Providers in Mary Esther, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.