Individual provider Active NPI

Duanne Lafrenz, MSW, LCSW

  • Clinical Social Worker
  • Lake Geneva, WI
National Provider Identifier
1124057294
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12-123 Issued in WI
Practice address
101 Broad St
Suite 201
Lake Geneva, WI 53147-2000
Phone
(262) 248-7942
NPI assigned
Jul 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

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 12-123 WI Primary

Addresses

Primary practice location

101 Broad St
Suite 201
Lake Geneva, WI 53147-2000

Mailing address

101 Broad St
Suite 201
Lake Geneva, WI 53147-2000
Phone (262) 248-7942

Other identifiers 1

IdentifierTypeStateIssuer
39509900MedicaidWI

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
I20071114000252 WI Practitioner - Clinical Social Worker 8527156256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Geneva Wellness Clinic LLCGroup PAC ID 7517139447, 7 clinicians

Practice addresses (Care Compare)

750 Veterans Pkwy
Lake Geneva, WI 53147-4950
Phone (262) 248-7942

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Geneva Wellness Clinic LLC CurrentSince Aug 2, 2011 Accepting new patients

Locations

750 Veterans Pkwy
Unit 100
Lake Geneva, WI 53147
Phone (262) 248-7942

101 Broad St
Ste 201
Lake Geneva, WI 53147
Phone (262) 248-7942

1001 W Glen Oaks Ln
Ste 105
Mequon, WI 53092
Phone (414) 258-8314

Organizations & group practices 1

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": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1124057294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BROAD ST",
            "address_2": "SUITE 201",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472000",
            "telephone_number": "262-248-7942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BROAD ST",
            "address_2": "SUITE 201",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472000",
            "telephone_number": "262-248-7942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFRENZ",
        "first_name": "DUANNE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-01",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "12-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39509900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Geneva, WI

Sources for this page

Verify at the official NPI Registry.