Jill M Cisar
Individual provider Active NPI Clinical Social Worker · Menasha, WI
NPI 1043494578 · NPPES record last updated Dec 4, 2008
Key facts
- NPI
- 1043494578
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 966-121 (WI)
- Practice address
- 1095 Midway Rd
Menasha, WI 54952-1115 - Phone
- (920) 720-2300
- Fax
- (920) 720-3806
- NPI assigned
- Dec 19, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 966-121 | WI | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 966-121 | WI | Yes |
Addresses
Primary practice location
1095 Midway Rd
Menasha, WI 54952-1115
Mailing address
1095 Midway Rd
Menasha, WI 54952-1115
Phone (920) 720-3702
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43567900 | Medicaid | WI |
Other providers in Menasha, WI
- La Chang
- Jennifer Chartier
- Melissa Lynn Chavas
- Theresa L Chinnery
- Reegan Chisholm
- Carri Ann Ciske
- City of Menasha Finance Department
- Clarity Hearts LLC
- Samantha Clark
- Philip James Clayton
All providers in Menasha, WI · Clinical Social Worker in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.