Kelsey Ann Martin, LCSW, CSAC, ICS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

9224 Issued in WI

Practice address

571 Braund St
Onalaska, WI 54650-8556

Phone

(608) 785-7000

Fax

(608) 785-7477

NPI assigned

Mar 13, 2018

Last updated

Feb 17, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Kelsey Ann Mader Former name

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Winona Health Services

  • General Acute Care Hospital
  • Winona, MN
  • NPI 1295789352
  Medicare reassignment NPD
• Stein Counseling and Consulting Services, LTD.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1861592891
  NPD (past)

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

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1104329432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 ISLAND ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546032848",
            "telephone_number": "920-420-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 BRAUND ST",
            "city": "ONALASKA",
            "state": "WI",
            "postal_code": "546508556",
            "telephone_number": "608-785-7000",
            "fax_number": "608-785-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KELSEY",
        "middle_name": "ANN",
        "credential": "LCSW, CSAC, ICS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-13",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100076316",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "MADER",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel C Maccharles, MD
• Stephen W Maden, PT
• Maplewood Dental
• Tiffany Jean Marinier, D.O.
• Courtney Marie Marten, RDH, OMT
• Rebecca Lynn Mattie, OTR/L
• Adam David Matz, PHARMD
• Steven Allen Mayer, RPH
• Mayo Clinic Health System-Southwest Wisconsin Region, Inc. (Onalaska Pharmacy)
• Mayo Clinic Hospital-Rochester

• Clinical Social Worker in Onalaska, WI
• Providers in Onalaska, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.