Active NPI
Karen Carnabucci, MSS, LCSW, TEP
- Clinical Social Worker
- Racine, WI
National Provider Identifier
1992916910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6834-123
- Practice address
- 932 Lake Ave
Lake House Health & Learning Center
Racine, WI 53403-1519 - Phone
- (262) 633-2645
- NPI assigned
- May 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 6834-123 | WI | Primary |
Addresses
Primary practice location
932 Lake Ave
Lake House Health & Learning Center
Racine, WI 53403-1519
Mailing address
932 Lake Ave.
Lake House Health & Learning Center
Racine, WI 53403
Phone (262) 633-2645
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43596400 | 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 |
|---|---|---|---|
| 6834-123 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1992916910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "932 LAKE AVE.",
"address_2": "LAKE HOUSE HEALTH & LEARNING CENTER",
"city": "RACINE",
"state": "WI",
"postal_code": "53403",
"telephone_number": "262-633-2645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "932 LAKE AVE",
"address_2": "LAKE HOUSE HEALTH & LEARNING CENTER",
"city": "RACINE",
"state": "WI",
"postal_code": "534031519",
"telephone_number": "262-633-2645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARNABUCCI",
"first_name": "KAREN",
"credential": "MSS, LCSW, TEP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-24",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "6834-123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43596400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Racine, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.