Individual provider Active NPI

Susan K. Walsh, LCSW

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1093798498
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2850-123 Issued in WI
Practice address
2021 N 60TH St
Milwaukee, WI 53208-1641
Phone
(414) 771-2881
Fax
(414) 771-1674
NPI assigned
Nov 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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 2850-123 WI Primary

Addresses

Primary practice location

2021 N 60TH St
Milwaukee, WI 53208-1641

Mailing address

800 Wisconsin Ave
Racine, WI 53403-1526
Phone (262) 637-8888

Other identifiers 1

IdentifierTypeStateIssuer
39677500MedicaidWI

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
I20110303000784 WI Practitioner - Clinical Social Worker 7517149198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Wisconsin School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2021 N 60TH St
Milwaukee, WI 53208-1641
Phone (414) 771-2881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2850WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities of the Archdiocese of Milwaukee Inc CurrentSince Nov 1, 2003 Accepting new patients
Catholic Charities of the Archdiocese of Milwaukee Inc Clinical Current Accepting new patients
Catholic Charities of the Archdiocese of Milwaukee Inc CurrentSince Nov 1, 2003 Accepting new patients
Catholic Charities of the Archdiocese of Milwaukee Inc Past Accepting new patients

Locations

2021 N 60th St
Milwaukee, WI 53208
Phone (414) 771-2881

800 Wisconsin Ave
Racine, WI 53403
Phone (262) 637-8888

Interoperability endpoints

  • Direct secure messaging: catholiccharities.susankwalsh@124096.advancedmd-direct.com

Organizations & group practices 4

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": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1093798498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WISCONSIN AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031526",
            "telephone_number": "262-637-8888",
            "fax_number": "262-637-0695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 N 60TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532081641",
            "telephone_number": "414-771-2881",
            "fax_number": "414-771-1674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "SUSAN",
        "middle_name": "K.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2850-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39677500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.