Individual provider Active NPI

Patrick Paul Westerham, MSW, LCSW, LICSW

  • Clinical Social Worker
  • Hudson, WI
National Provider Identifier
1053577361
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7914-123 Issued in WI
Practice address
131 Carmichael Rd Ste 206
Hudson, WI 54016-8271
Phone
(715) 318-1174
Fax
(651) 314-0350
NPI assigned
Aug 6, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 14182 MN
Clinical Social Worker 1041C0700X 7914-123 WI Primary

Addresses

Primary practice location

131 Carmichael Rd Ste 206
Hudson, WI 54016-8271

Mailing address

131 Carmichael Rd Ste 206
Hudson, WI 54016-8271
Phone (715) 318-1174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190529000546 MN Practitioner - Clinical Social Worker 0840509717 Reassigns benefits to 1 organization
I20190923001471 WI Practitioner - Clinical Social Worker 0840509717 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
River Valley Counseling, LLCGroup PAC ID 4981122736, 6 clinicians

Practice addresses (Care Compare)

131 Carmichael Rd
Suite 206
Hudson, WI 54016-8271
Phone (715) 690-2115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7914-123WIMDMental Health Counselor
14182MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Counseling Services, Inc CurrentSince Mar 1, 2023 Accepting new patients
River Valley Counseling, LLC CurrentSince Apr 1, 2025 Accepting new patients
West Central Counseling LLC Clinical PastSince Jun 6, 2021 Accepting new patients

Locations

131 Carmichael Rd
Ste 206
Hudson, WI 54016
Phone (715) 690-2115

10850 W Park Pl
Ste 100
Milwaukee, WI 53224
Phone (414) 361-4100

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.patrickwesterham@149809.advancedmd-direct.com
  • Direct secure messaging: patrick.westerham.1@32669.direct.athenahealth.com

Organizations & group practices 4

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": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1053577361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 CARMICHAEL RD STE 206",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168271",
            "telephone_number": "715-318-1174",
            "fax_number": "651-314-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 CARMICHAEL RD STE 206",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168271",
            "telephone_number": "715-318-1174",
            "fax_number": "651-314-0350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTERHAM",
        "first_name": "PATRICK",
        "middle_name": "PAUL",
        "credential": "MSW, LCSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-06",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "14182",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7914-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, WI

Sources for this page

Verify at the official NPI Registry.