Individual provider Active NPI

Sheryl L. Graeber

  • Clinical Social Worker
  • Oshkosh, WI
National Provider Identifier
1083850796
Registry record updated Dec 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3374-123 Issued in WI
Practice address
515 S Washburn St
Oshkosh, WI 54904-7975
Phone
(920) 236-8570
NPI assigned
Dec 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 12903-131 WI
Clinical Social Worker 1041C0700X 3374-123 WI Primary

Addresses

Primary practice location

515 S Washburn St
Oshkosh, WI 54904-7975

Mailing address

1570 Midway PL
Menasha, WI 54952-1165
Phone (920) 720-1464

Other identifiers 1

IdentifierTypeStateIssuer
43745330MedicaidWI

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
12903-131WIMDAddiction (Substance Use Disorder) Counselor
3374-123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1230595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230595200000",
    "number": "1083850796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 MIDWAY PL",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521165",
            "telephone_number": "920-720-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S WASHBURN ST",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047975",
            "telephone_number": "920-236-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAEBER",
        "first_name": "SHERYL",
        "middle_name": "L.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-30",
        "last_updated": "2008-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "12903-131",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "3374-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43745330",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2008; 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.