Individual provider Active NPI

Carol Palmert

  • Clinical Social Worker
  • Waukesha, WI
National Provider Identifier
1982701991
Registry record updated Mar 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7175-123 Issued in WI
Practice address
2314 N Grandview Blvd
#309
Waukesha, WI 53188-1675
Phone
(262) 544-4540
NPI assigned
Sep 20, 2006
Last updated
Mar 22, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7175-123 WI Primary
Marriage & Family Therapist 106H00000X 681-124 WI

Addresses

Primary practice location

2314 N Grandview Blvd
#309
Waukesha, WI 53188-1675

Mailing address

2314 N Grandview Blvd
#309
Waukesha, WI 53188-1675

Other identifiers 2

IdentifierTypeStateIssuer
681-124OtherWISTATE OF WISC LICENSE
7175-123OtherWISTATE OF WISC LICENSE

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

LicenseStateTypeSpecialty
7175-123WIMDClinical Social Worker
681-124WIMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269216000000",
    "number": "1982701991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 N GRANDVIEW BLVD",
            "address_2": "#309",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 N GRANDVIEW BLVD",
            "address_2": "#309",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881675",
            "telephone_number": "262-544-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMERT",
        "first_name": "CAROL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7175-123",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "681-124",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WISC LICENSE",
            "identifier": "681-124",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF WISC LICENSE",
            "identifier": "7175-123",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; 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.