Individual provider Active NPI

Nancy J Pohlman

  • Clinical Social Worker
  • La Crosse, WI
National Provider Identifier
1033777800
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9864-123 Issued in WI
Practice address
605 4TH St S
La Crosse, WI 54601-4458
Phone
(608) 615-1023
Fax
(608) 615-1063
NPI assigned
Jun 5, 2019
Last updated
Jan 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9864-123 WI Primary

Addresses

Primary practice location

605 4TH St S
La Crosse, WI 54601-4458

Mailing address

605 4TH St S
La Crosse, WI 54601-4458
Phone (608) 615-1023

Other identifiers 1

IdentifierTypeStateIssuer
100089192MedicaidWI

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
I20221010002534 WI Practitioner - Clinical Social Worker 2961888292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Wisconsin School of Medicine, 1996
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

605 4TH St S
La Crosse, WI 54601-4458
Phone (608) 386-5495

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Brave Spaces Counseling and Wellness, LLC Clinical CurrentSince Jun 1, 2022 Accepting new patients
Peace of Mind Counseling LLC PastSince Sep 1, 2018 Accepting new patients

Locations

605 4th St S
La Crosse, WI 54601
Phone (608) 386-5495

121 W Franklin St
Sparta, WI 54656
Phone (608) 386-4160

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1033777800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 4TH ST S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014458",
            "telephone_number": "608-615-1023",
            "fax_number": "608-615-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 4TH ST S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014458",
            "telephone_number": "608-615-1023",
            "fax_number": "608-615-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POHLMAN",
        "first_name": "NANCY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9864-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100089192",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.