Individual provider Active NPI

Allison E Pohlman, LCSW

  • Clinical Social Worker
  • Green Bay, WI
National Provider Identifier
1184922940
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1496 Bellevue St
Suite 101
Green Bay, WI 54311-4205
Phone
(920) 784-2644
Fax
(920) 784-2655
NPI assigned
Mar 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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 Primary

Addresses

Primary practice location

1496 Bellevue St
Suite 101
Green Bay, WI 54311-4205

Mailing address

1496 Bellevue St
Suite 101
Green Bay, WI 54311-4205
Phone (920) 784-2644

Other identifiers 1

IdentifierTypeStateIssuer
100029360MedicaidWI

Other names 1

  • Allison E Augustine 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
I20141020000134 WI Practitioner - Clinical Social Worker 9133340086 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Behavioral Health LLCGroup PAC ID 2961713359, 2 clinicians

Practice addresses (Care Compare)

1496 Bellevue St
Suite 101
Green Bay, WI 54311-4205
Phone (920) 784-2644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Behavioral Health LLC CurrentSince May 17, 2015 Accepting new patients
Innovative Counseling Inc CurrentSince Jun 16, 2014 Accepting new patients

Locations

1496 Bellevue St
#101
Green Bay, WI 54311
Phone (920) 784-2644

1496 Bellevue St
Ste 101
Green Bay, WI 54311
Phone (920) 784-2644

1499 6th St
Green Bay, WI 54304
Phone (920) 497-6161

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.

NPI Registry JSON

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1184922940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1496 BELLEVUE ST",
            "address_2": "SUITE 101",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114205",
            "telephone_number": "920-784-2644",
            "fax_number": "920-784-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1496 BELLEVUE ST",
            "address_2": "SUITE 101",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114205",
            "telephone_number": "920-784-2644",
            "fax_number": "920-784-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POHLMAN",
        "first_name": "ALLISON",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-03",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100029360",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLISON",
            "last_name": "AUGUSTINE",
            "middle_name": "E",
            "credential": "APSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.