Individual provider Active NPI

Anne Catherine Paczesny, LCSW

  • Clinical Social Worker
  • Elm Grove, WI
National Provider Identifier
1053634089
Registry record updated May 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2545 Issued in WI
Practice address
890 Elm Grove Rd
Suite 208
Elm Grove, WI 53122-2528
Phone
(414) 403-0524
Fax
(262) 285-3286
NPI assigned
Mar 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2014

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 2545 WI Primary

Addresses

Primary practice location

890 Elm Grove Rd
Suite 208
Elm Grove, WI 53122-2528

Mailing address

890 Elm Grove Rd
Suite 208
Elm Grove, WI 53122-2528
Phone (414) 403-0524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2545WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400371200000",
    "number": "1053634089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 ELM GROVE RD",
            "address_2": "SUITE 208",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222528",
            "telephone_number": "414-403-0524",
            "fax_number": "262-285-3286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 ELM GROVE RD",
            "address_2": "SUITE 208",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222528",
            "telephone_number": "414-403-0524",
            "fax_number": "262-285-3286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACZESNY",
        "first_name": "ANNE",
        "middle_name": "CATHERINE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-04",
        "last_updated": "2014-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elm Grove, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2014; 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.