NPIMap

Organization Active NPI

Rusk County CSP

  • Community/Behavioral Health Agency
  • Ladysmith, WI
National Provider Identifier
1053586412
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
RUSK COUNTY CSP
Practice address
219 W 2ND St North
Lady Smith, WI 54848
Phone
(715) 532-5940
Fax
(715) 532-5947
NPI assigned
Apr 28, 2008
Last updated
Apr 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Authorized official

Name
Ms. Pamela Olson, LICENSED CLINCAL SOC
Title
Clinical Coordinator
Phone
(715) 532-5940

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X WI Primary

Addresses

Primary practice location

219 W 2ND St North
Lady Smith, WI 54848

Mailing address

219 W 2ND St North
Ladysmith, WI 54848
Phone (715) 532-5940

Other identifiers 1

IdentifierTypeStateIssuer
43429800MedicaidWI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1053586412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 W 2ND ST NORTH",
            "city": "LADYSMITH",
            "state": "WI",
            "postal_code": "54848",
            "telephone_number": "715-532-5940",
            "fax_number": "715-532-5947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 W 2ND ST NORTH",
            "city": "LADY SMITH",
            "state": "WI",
            "postal_code": "54848",
            "telephone_number": "715-532-5940",
            "fax_number": "715-532-5947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSK COUNTY CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-28",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "CLINICAL COORDINATOR",
        "authorized_official_telephone_number": "715-532-5940",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LICENSED CLINCAL SOC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43429800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ladysmith, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.