Individual provider Active NPI

Marianne Elizabeth Beyersdorf, LCSW

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1083112320
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9486-123 Issued in WI
Practice address
2215 N Palmer St
Milwaukee, WI 53212-3242
Phone
(800) 438-1772
Fax
(262) 345-5562
NPI assigned
Jan 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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 130880 WI
Clinical Social Worker 1041C0700X 9486-123 WI Primary

Addresses

Primary practice location

2215 N Palmer St
Milwaukee, WI 53212-3242

Mailing address

W175N11120 Stonewood Dr
Germantown, WI 53022-4799
Phone (888) 685-9522

Other names 1

  • Marianne Loescher Former name

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
130880WIMDClinical Social Worker
9486-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wisconsin Lutheran Child and Family Service Inc Clinical PastSince Jul 28, 2019 Accepting new patients
Wisconsin Lutheran Child & Family Service PastSince Jul 28, 2019 Accepting new patients

Organizations & group practices 2

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": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1083112320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W175N11120 STONEWOOD DR",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530224799",
            "telephone_number": "888-685-9522",
            "fax_number": "622-345-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 N PALMER ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532123242",
            "telephone_number": "800-438-1772",
            "fax_number": "262-345-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYERSDORF",
        "first_name": "MARIANNE",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "130880",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9486-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIANNE",
            "last_name": "LOESCHER",
            "credential": "APSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.