Individual provider Active NPI

Chloe Anderson Kemp, LCSW

  • Clinical Social Worker
  • Appleton, WI
National Provider Identifier
1164077103
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9770-123 Issued in WI
Practice address
4650 W Spencer St
Appleton, WI 54914-9106
Phone
(920) 903-1060
Fax
(920) 903-1164
NPI assigned
Aug 6, 2019
Last updated
Sep 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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 9770-123 WI Primary

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 names 1

  • Chloe Anderson Former name

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
I20210916002963 WI Practitioner - Clinical Social Worker 6608273784 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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.Group PAC ID 1557691151, 5 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

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

Locations

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

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

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, 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": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1164077103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SPENCER ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549149106",
            "telephone_number": "920-903-1060",
            "fax_number": "920-903-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SPENCER ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549149106",
            "telephone_number": "920-903-1060",
            "fax_number": "920-903-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON KEMP",
        "first_name": "CHLOE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9770-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHLOE",
            "last_name": "ANDERSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.