Chloe Anderson Kemp, LCSW

Individual provider Active NPI Clinical Social Worker · Appleton, WI

NPI 1164077103 · NPPES record last updated Sep 5, 2024

Key facts

NPI
1164077103
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
9770-123 (WI)
Practice address
4650 W Spencer St
Appleton, WI 54914-9106
Phone
(920) 903-1060
Fax
(920) 903-1164
NPI assigned
Aug 6, 2019
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
US 2 Behavioral Health Care Inc. (5 clinicians)

Practice addresses (Care Compare)

4650 W Spencer St
Appleton, WI 54914-9106
Phone (920) 903-1060

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210916002963 WI Practitioner - Clinical Social Worker 6608273784 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
US 2 Behavioral Health Care Inc Current
since Sep 3, 2021
Accepting new patients
Power for Change, LLC Past
since Oct 17, 2021
Accepting new patients

Locations

4650 W Spencer St
Appleton, WI 54914
Phone (920) 903-1060

119 N McCarthy Rd
Ste P
Appleton, WI 54913
Phone (920) 903-1060

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9770-123 WI Yes

Addresses

Primary practice location

4650 W Spencer St
Appleton, WI 54914-9106

Mailing address

4650 W Spencer St
Appleton, WI 54914-9106
Phone (920) 903-1060

Other identifiers

IdentifierTypeStateIssuer
100091832MedicaidWI

Other names

  • Chloe Anderson Former name

Other providers in Appleton, WI

All providers in Appleton, WI · Clinical Social Worker in Wisconsin

Sources for this page

Verify at the official NPI Registry.