Individual provider Active NPI

Helen F Jurgensen, LCSW MSW

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1083749766
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW583123 Issued in WI
Practice address
5508 W Vliet St
Milwaukee, WI 53208-8003
Phone
(414) 476-1073
Fax
(414) 476-0223
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LCSW583123 WI Primary

Addresses

Primary practice location

5508 W Vliet St
Milwaukee, WI 53208-8003

Mailing address

PO Box 080196
Milwaukee, WI 53208-8003
Phone (414) 476-1073

Other identifiers 1

IdentifierTypeStateIssuer
280196OtherWIVALUE OPTIONS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040608001054 WI Practitioner - Clinical Social Worker 9335122795 Practice locations: Milwaukee, WI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5508 W Vliet St
Milwaukee, WI 53208-2120
Phone (414) 476-1073

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW583123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083749766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 080196",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532088003",
            "telephone_number": "414-476-1073",
            "fax_number": "414-476-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5508 W VLIET ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532088003",
            "telephone_number": "414-476-1073",
            "fax_number": "414-476-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURGENSEN",
        "first_name": "HELEN",
        "middle_name": "F",
        "name_prefix": "Ms.",
        "credential": "LCSW MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "LCSW583123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "280196",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.