Individual provider Active NPI

Tejuana L King, MSW, LCSW, CSAC

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1184701088
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7256-123 Issued in WI
Practice address
1126 S. 70TH Street
Suite S-507
Milwaukee, WI 53214
Phone
(414) 727-2789
Fax
(414) 476-8695
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 13881-132 WI
Clinical Social Worker 1041C0700X 7256-123 WI Primary

Addresses

Primary practice location

1126 S. 70TH Street
Suite S-507
Milwaukee, WI 53214

Mailing address

1126 S. 70TH Street
Suite S-507
Milwaukee, WI 53214
Phone (414) 727-2789

Other identifiers 1

IdentifierTypeStateIssuer
40976800MedicaidWI

Other names 1

  • Tejuana L Lipsey Former name

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

State licenses

LicenseStateTypeSpecialty
13881-132WIMDAddiction (Substance Use Disorder) Counselor
7256-123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1184701088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 S. 70TH STREET",
            "address_2": "SUITE S-507",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53214",
            "telephone_number": "414-727-2789",
            "fax_number": "414-476-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 S. 70TH STREET",
            "address_2": "SUITE S-507",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53214",
            "telephone_number": "414-727-2789",
            "fax_number": "414-476-8695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "TEJUANA",
        "middle_name": "L",
        "credential": "MSW, LCSW, CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "13881-132",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7256-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40976800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TEJUANA",
            "last_name": "LIPSEY",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.