Individual provider Active NPI

Danielle M Evenson, LCSW

  • Clinical Social Worker
  • De Pere, WI
National Provider Identifier
1184092884
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8376-123 Issued in WI
Practice address
1325 Angels Path
De Pere, WI 54115-4050
Phone
(920) 338-2855
Fax
(920) 338-9270
NPI assigned
Sep 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 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 8376-123 WI Primary

Addresses

Primary practice location

1325 Angels Path
De Pere, WI 54115-4050

Mailing address

PO Box 22040
Green Bay, WI 54305-2040
Phone (920) 445-7210

Other practice location 1

301 E Saint Joseph St
Green Bay, WI 54301-2241
Phone (920) 433-6073

Other names 1

  • Danielle Marie Buettner 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
I20181001003450 WI Practitioner - Clinical Social Worker 1951652916 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

1325 Angels Path
De Pere, WI 54115-4050
Phone (920) 338-2855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8376-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Psychiatric Center Inc Current Accepting new patients
Bellin Psychiatric Center Inc CurrentSince Sep 24, 2018 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince May 19, 2025 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince May 19, 2025 Accepting new patients
Bellin Psychiatric Center Inc. Clinical CurrentSince Sep 24, 2018 Accepting new patients

Locations

1325 Angels Path
De Pere, WI 54115
Phone (920) 338-2855

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

835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246

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

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1184092884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22040",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052040",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 ANGELS PATH",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541154050",
            "telephone_number": "920-338-2855",
            "fax_number": "920-338-9270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E Saint Joseph St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543012241",
            "country_code": "US",
            "telephone_number": "920-433-6073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVENSON",
        "first_name": "DANIELLE",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-11",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8376-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "BUETTNER",
            "middle_name": "MARIE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in De Pere, WI

Sources for this page

Verify at the official NPI Registry.