Individual provider Active NPI

Wanda Jean Schafer, MS

  • Clinical Social Worker
  • La Crosse, WI
National Provider Identifier
1164535324
Registry record updated Jan 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3847-123 Issued in WI
Practice address
1707 Main St
La Crosse, WI 54601-4200
Phone
(608) 788-6322
Fax
(608) 785-0002
NPI assigned
Aug 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2008

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 3847-123 WI Primary
Marriage & Family Therapist 106H00000X 63-124 WI

Addresses

Primary practice location

1707 Main St
La Crosse, WI 54601-4200

Mailing address

66 E 3Rd St
2
Winona, MN 55987-3478
Phone (507) 452-7292

Other identifiers 2

IdentifierTypeStateIssuer
39281800MedicaidWI
016L6SCOtherMNBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3847WIMDProfessional Counselor
3847-123WIMDClinical Social Worker
63-124WIMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199750400000",
    "number": "1164535324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 E 3RD ST",
            "address_2": "2",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559873478",
            "telephone_number": "507-452-7292",
            "fax_number": "507-457-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 MAIN ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014200",
            "telephone_number": "608-788-6322",
            "fax_number": "608-785-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAFER",
        "first_name": "WANDA",
        "middle_name": "JEAN",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2008-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "3847-123",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "63-124",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39281800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "016L6SC",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.