Individual provider Active NPI

Barbara Jo Bunnell, MSW, LCSW, SAC-IT

  • Clinical Social Worker
  • Wausau, WI
National Provider Identifier
1093078784
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9226-123 Issued in WI
Practice address
1810 N 2ND St
Wausau, WI 54403-3492
Phone
(715) 848-4884
NPI assigned
Jun 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X 9226-123 WI Primary

Addresses

Primary practice location

1810 N 2ND St
Wausau, WI 54403-3492

Mailing address

1812 N 2ND St
Wausau, WI 54403

Other practice location 1

N6654 Rolling Meadows Dr
Fond Du Lac, WI 54937-9471
Phone (920) 906-5100

Other practice location 2

1991 Winnebago Dr
Rhinelander, WI 54501
Phone (715) 362-5745

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
I20200325003498 WI Practitioner - Clinical Social Worker 3870921869 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Centre for Well-Being, IncGroup PAC ID 6002083920, 26 clinicians

Practice addresses (Care Compare)

901 N 6TH St
Wausau, WI 54403-4718
Phone (715) 848-5022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9226-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Centre for Well-Being, Inc CurrentSince Jan 3, 2022 Accepting new patients
Primary Connection Health Care, Inc. CurrentSince Feb 26, 2020 Accepting new patients
The Human Service Center Koinonia Residential Treatment Center Past Accepting new patients
Lakeland Care Inc Past Accepting new patients
Options Counseling Services, LLC PastSince Dec 1, 2015 Accepting new patients

Locations

1810 N 2nd St
Wausau, WI 54403
Phone (715) 848-4884

901 N 6th St
Wausau, WI 54403
Phone (715) 848-5022

Organizations & group practices 6

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": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1093078784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 N 2ND ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "54403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 N 2ND ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544033492",
            "telephone_number": "715-848-4884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N6654 Rolling Meadows Dr",
            "address_purpose": "LOCATION",
            "city": "Fond Du Lac",
            "state": "WI",
            "postal_code": "549379471",
            "country_code": "US",
            "telephone_number": "920-906-5100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1991 Winnebago Dr",
            "address_purpose": "LOCATION",
            "city": "Rhinelander",
            "state": "WI",
            "postal_code": "54501",
            "country_code": "US",
            "telephone_number": "715-362-5745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUNNELL",
        "first_name": "BARBARA JO",
        "credential": "MSW, LCSW, SAC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9226-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.