Individual provider Active NPI

Brandy N Jastrow, LCSW

  • Clinical Social Worker
  • Crandon, WI
National Provider Identifier
1124521414
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9535-123 Issued in WI
Practice address
PO Box 396
Crandon, WI 54520-0396
Phone
(715) 478-4339
Fax
(715) 478-4494
NPI assigned
Mar 13, 2018
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801108974 MI
Clinical Social Worker 1041C0700X 9535-123 WI Primary

Addresses

Primary practice location

PO Box 396
Crandon, WI 54520-0396

Mailing address

1635 Maple LN
Ashland, WI 54806-3610
Phone (715) 685-5400

Other practice location 1

2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225

Other identifiers 1

IdentifierTypeStateIssuer
130878-121OtherWISTATE LICENSE

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
I20230706001220 WI Practitioner - Clinical Social Worker 8729494406 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Indiana Medical College, School of Medicine of Purdue University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

1693 Huron St
Three Lakes, WI 54562-9763
Phone (920) 445-7210

Merit-based Incentive Payment System (MIPS)

Final score
87.84 of 100Reported as group
Quality
86.21
Promoting interoperability
100
Improvement activities
40
Cost
73.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801108974MIMDClinical Social Worker
9535-123WIMDClinical Social Worker
9535WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Oct 9, 2025 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Oct 9, 2025 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Oct 9, 2025 Accepting new patients
Forest County Potawatomi Community CurrentSince Aug 26, 2024 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Oct 9, 2025 Accepting new patients
Memorial Medical Center Inc Past Accepting new patients

Locations

8201 Mish Ko Swen Dr
Crandon, WI 54520
Phone (715) 478-4300

301 Saint Joseph St
Green Bay, WI 54301
Phone (920) 430-3630

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1124521414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 MAPLE LN",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548063610",
            "telephone_number": "715-685-5400",
            "fax_number": "715-685-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 396",
            "city": "CRANDON",
            "state": "WI",
            "postal_code": "545200396",
            "telephone_number": "715-478-4339",
            "fax_number": "715-478-4494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2820 Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541433834",
            "country_code": "US",
            "telephone_number": "715-735-5225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JASTROW",
        "first_name": "BRANDY",
        "middle_name": "N",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-13",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801108974",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9535-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "130878-121",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crandon, WI

Sources for this page

Verify at the official NPI Registry.