Individual provider Active NPI

Jessica Ann Weyer, MSW RAPCI LCSW

  • Social Worker
  • Milwaukee, WI
National Provider Identifier
1104924018
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
2675 N Mayfair Rd Ste 400
Milwaukee, WI 53226-1305
Phone
(414) 763-6910
Fax
(414) 763-6911
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7359-123 WI
Addiction (Substance Use Disorder) Counselor 101YA0400X 12995 WI
Social Worker 104100000X Primary

Addresses

Primary practice location

2675 N Mayfair Rd Ste 400
Milwaukee, WI 53226-1305

Mailing address

10921 Glenway CT
Milwaukee, WI 53222-1120
Phone (920) 973-0167

Other practice location 1

3900 W Brown Deer Rd
Suite 200
Brown Deer, WI 53209
Phone (414) 540-2170

Other identifiers 4

IdentifierTypeStateIssuer
41008500MedicaidWI
126638121OtherWIAPSW
12995OtherWIRADCI
15144-132OtherWICLINICAL SUBSTANCE ABUSE COUNSELOR

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
I20080513000324 WI Practitioner - Clinical Social Worker 6204905524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Wisconsin School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Frontiers Psychiatric SCGroup PAC ID 7416201058, 9 clinicians

Practice addresses (Care Compare)

2675 N Mayfair Rd
Suite 400
Milwaukee, WI 53226-1305
Phone (414) 763-6910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12995WIMDAddiction (Substance Use Disorder) Counselor
7359-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New Frontiers Psychiatric SC CurrentSince May 20, 2025 Accepting new patients
New Frontiers TMS LLC CurrentSince May 18, 2025 Accepting new patients
Shorehaven Behavioral Health Inc Addiction (Substance Use Disorder) CurrentSince Jul 1, 2007 Accepting new patients

Locations

2675 N Mayfair Rd
Ste 400
Milwaukee, WI 53226
Phone (414) 350-2449

3900 W Brown Deer Rd
Ste 200
Milwaukee, WI 53209

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1104924018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10921 GLENWAY CT",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221120",
            "telephone_number": "920-973-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 N MAYFAIR RD STE 400",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532261305",
            "telephone_number": "414-763-6910",
            "fax_number": "414-763-6911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 W Brown Deer Rd",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Brown Deer",
            "state": "WI",
            "postal_code": "53209",
            "country_code": "US",
            "telephone_number": "414-540-2170",
            "fax_number": "414-540-2171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEYER",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MSW RAPCI LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7359-123",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "12995",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41008500",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APSW",
            "identifier": "126638121",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RADCI",
            "identifier": "12995",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL SUBSTANCE ABUSE COUNSELOR",
            "identifier": "15144-132",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.