Provider Demographics
NPI:1427024678
Name:DEGARMO-HAAKENSON, KARLA J (LCSW)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:J
Last Name:DEGARMO-HAAKENSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:J
Other - Last Name:HAAKENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2825 PRAIRIE AVE
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-1844
Mailing Address - Country:US
Mailing Address - Phone:608-368-3320
Mailing Address - Fax:608-365-2709
Practice Address - Street 1:2825 PRAIRIE AVE
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-1844
Practice Address - Country:US
Practice Address - Phone:608-368-3320
Practice Address - Fax:608-365-2709
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1535-123101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40913800Medicaid
WIHAAKEKAR-MOOtherMERCYCARE INSURANCE
WI1427024678OtherBCBSWI
WI1427024678Medicaid
WI84908-0054OtherWI MEDICARE