Individual provider Active NPI

Signe M Midelfort-Hector, LICSW

  • Clinical Social Worker
  • Onalaska, WI
National Provider Identifier
1073203642
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11410 Issued in WI
Practice address
123 16TH Ave S
Onalaska, WI 54650-3109
Phone
(608) 775-2287
NPI assigned
May 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 29392 MN
Clinical Social Worker 1041C0700X 11410 WI Primary

Addresses

Primary practice location

123 16TH Ave S
Onalaska, WI 54650-3109

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smidelforthector831362@direct.gundersenhealth.org Direct

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
I20230727002337 MN Practitioner - Clinical Social Worker 1254792955 Reassigns benefits to 1 organization
I20231214000983 WI Practitioner - Clinical Social Worker 1254792955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gundersen Lutheran Medical Center IncGroup PAC ID 2163331414, 888 clinicians

Practice addresses (Care Compare)

123 16TH Ave S
Gundersen Lutheran Behavioral Health Onalas
Onalaska, WI 54650-3109
Phone (608) 775-2287

1836 S Ave
La Crosse, WI 54601-5429
Phone (608) 783-7300

1910 S Ave
La Crosse, WI 54601-5467
Phone (608) 782-7300

2575 S 7TH St
Bethany Riverside
La Crosse, WI 54601-5429
Phone (608) 775-8200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29392MNMDMental Health Counselor
11410WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Gundersen Lutheran Medical Center, Inc. CurrentSince Dec 11, 2023 Accepting new patients
St. Croix Psychiatric, LLC Mental Health CurrentSince Jun 3, 2023 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Dec 11, 2023 Accepting new patients
Gundersen Lutheran Medical Center Inc Past Accepting new patients

Locations

9400 Zane Ave N
Minneapolis, MN 55443
Phone (763) 383-5800

4510 77th St W
Minneapolis, MN 55435
Phone (952) 230-9100

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

123 16th Ave S
Onalaska, WI 54650
Phone (608) 775-2287

Organizations & group practices 5

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": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1073203642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 16TH AVE S",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546503109",
            "telephone_number": "608-775-2287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDELFORT-HECTOR",
        "first_name": "SIGNE",
        "middle_name": "M",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "29392",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smidelforthector831362@direct.gundersenhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "123 16th Ave S",
            "city": "Onalaska",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546503109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Onalaska, WI

Sources for this page

Verify at the official NPI Registry.