Individual provider Active NPI

Christine Preston, MWWS, LCSW

  • Clinical Social Worker
  • Baraboo, WI
National Provider Identifier
1104248160
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8652 Issued in WI
Practice address
S2845 White Eagle Rd
Baraboo, WI 53913
Phone
(608) 355-1240
NPI assigned
Jan 10, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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 8652 WI Primary

Addresses

Primary practice location

S2845 White Eagle Rd
Baraboo, WI 53913

Mailing address

S2845 White Eagle Rd
Baraboo, WI 53913-9064

Other identifiers 1

IdentifierTypeStateIssuer
100035224MedicaidWI

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
I20180612000683 WI Practitioner - Clinical Social Worker 4385999580 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Service Associates, SCGroup PAC ID 8426948746, 34 clinicians
Ho Chunk NationGroup PAC ID 5496709867, 30 clinicians

Practice addresses (Care Compare)

1002 Lincoln Ave
Baraboo, WI 53913-1808
Phone (608) 356-9055

S2845 White Eagle Rd
Baraboo, WI 53913-9064
Phone (608) 355-1240

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8652WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Service Associates, SC CurrentSince Jan 15, 2020 Accepting new patients

Locations

1002 Lincoln Ave
Baraboo, WI 53913
Phone (608) 356-9055

1341 Park Ave
Columbus, WI 53925
Phone (920) 623-2431

2901 Hunters Trl
Portage, WI 53901
Phone (608) 742-5518

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1104248160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S2845 WHITE EAGLE RD",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539139064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S2845 WHITE EAGLE RD",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "53913",
            "telephone_number": "608-355-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTON",
        "first_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "credential": "MWWS, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-10",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100035224",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baraboo, WI

Sources for this page

Verify at the official NPI Registry.