Individual provider Active NPI

Alex Hartwell, LCSW

  • Clinical Social Worker
  • Glendale, WI
National Provider Identifier
1083613517
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
420-123 Issued in WI
Practice address
5225 N Ironwood Rd
Ste 118
Glendale, WI 53217-4909
Phone
(414) 308-1091
Fax
(414) 308-1092
NPI assigned
Jul 18, 2005
Last updated
May 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2011

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 420-123 WI Primary

Addresses

Primary practice location

5225 N Ironwood Rd
Ste 118
Glendale, WI 53217-4909

Mailing address

5225 N Ironwood Rd
Ste 118
Glendale, WI 53217-4909
Phone (414) 308-1091

Other identifiers 1

IdentifierTypeStateIssuer
39590000MedicaidWI

Other names 1

  • Mr. Alex J Walkowiak 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)
Enrolled

State licenses

LicenseStateTypeSpecialty
420-123WIMDClinical Social Worker
420WIMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Psychology Associates, Inc. Past Accepting new patients
Joy of Life Center LTD PastSince Oct 27, 1979 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1083613517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 N IRONWOOD RD",
            "address_2": "STE 118",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174909",
            "telephone_number": "414-308-1091",
            "fax_number": "414-308-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 N IRONWOOD RD",
            "address_2": "STE 118",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174909",
            "telephone_number": "414-308-1091",
            "fax_number": "414-308-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTWELL",
        "first_name": "ALEX",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "420-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39590000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEX",
            "last_name": "WALKOWIAK",
            "middle_name": "J",
            "prefix": "MR.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; 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.