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NPI Code Detail

MEDICARE: MS. KARI LYNN DI FONZO LCSW,

MEDICARE: MS. KARI LYNN DI FONZO LCSW,
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker7270123WI
21041C0700XClinical Social Worker7270WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508965906
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KARI LYNN DI FONZO LCSW,
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number : 262-999-3495
Fax Number :
Provider Business Practice Location Address
First Line : 5555 N PORT WASHINGTON RD STE 200
Second Line :
City : GLENDALE
State : WI
Zip : 53217-4927
Country : US
Telephone Number : 262-999-3495
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 09/22/2025

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