Active NPI
Carolyn Mangan-Casey, LCSW
- Clinical Social Worker
- West Bend, WI
National Provider Identifier
1992811442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 67-123
- Practice address
- 333 E Washington St
Suite 2000
West Bend, WI 53095-2585 - Phone
- (262) 335-4545
- Fax
- (262) 335-6827
- NPI assigned
- Aug 21, 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 67-123 | WI | Primary |
Addresses
Primary practice location
333 E Washington St
Suite 2000
West Bend, WI 53095-2585
Mailing address
333 E Washington St
Suite 2000
West Bend, WI 53095-2585
Phone (262) 335-4545
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39595700 | 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 |
|---|---|---|---|
| 67-123 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992811442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 E WASHINGTON ST",
"address_2": "SUITE 2000",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530952585",
"telephone_number": "262-335-4545",
"fax_number": "262-335-6827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 E WASHINGTON ST",
"address_2": "SUITE 2000",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530952585",
"telephone_number": "262-335-4545",
"fax_number": "262-335-6827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGAN-CASEY",
"first_name": "CAROLYN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "67-123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39595700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Bend, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.