Individual provider Active NPI

Charles F Lawler, MSW, LMFT

  • Marriage & Family Therapist
  • West Allis, WI
National Provider Identifier
1013094911
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
708-124 Issued in WI
Practice address
1126 S. 70TH Street
Suite S-507
West Allis, WI 53214
Phone
(414) 727-2789
Fax
(414) 476-8695
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 708-124 WI Primary

Addresses

Primary practice location

1126 S. 70TH Street
Suite S-507
West Allis, WI 53214

Mailing address

1126 S. 70TH Street
Suite S-507
West Allis, WI 53214
Phone (414) 727-2789

Other identifiers 1

IdentifierTypeStateIssuer
40969000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240318001261 WI Practitioner - Marriage and Family Therapist 3577735174 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellness West LLCGroup PAC ID 4789052820, 6 clinicians

Practice addresses (Care Compare)

2428 N Grandview Blvd
Suite 101
Waukesha, WI 53188-6906
Phone (262) 259-4100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
708-124WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wellness West LLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

2428 N Grandview Blvd
Ste 101
Waukesha, WI 53188
Phone (262) 259-4100

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1013094911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 S. 70TH STREET",
            "address_2": "SUITE S-507",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "53214",
            "telephone_number": "414-727-2789",
            "fax_number": "414-476-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 S. 70TH STREET",
            "address_2": "SUITE S-507",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "53214",
            "telephone_number": "414-727-2789",
            "fax_number": "414-476-8695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWLER",
        "first_name": "CHARLES",
        "middle_name": "F",
        "credential": "MSW, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "708-124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40969000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.