Caitlin A Dufour, LCSW, SAC-IT

Individual provider Active NPI Clinical Social Worker · Hurley, WI

NPI 1194273987 · NPPES record last updated Nov 1, 2023

Key facts

NPI
1194273987
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
9470 (WI)
Practice address
115 5TH Ave N
Hurley, WI 54534-1208
Phone
(715) 329-1288
NPI assigned
Sep 21, 2016
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Lakes Community Health Center Inc (104 clinicians)

Practice addresses (Care Compare)

7665 US Hwy 2
Iron River, WI 54847-4690
Phone (715) 372-5001

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20231018003186 WI Practitioner - Clinical Social Worker 1456766724 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
6801100786MIMDSocial Worker
9470WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Lakes Community Health Center, Inc Current
since Oct 5, 2023
Accepting new patients
The Lakes Community Health Center, Inc Current
since Oct 5, 2023
Accepting new patients
The Lakes Community Health Center, Inc Current
since Nov 5, 2023
Accepting new patients

Locations

300 Main St W
Ashland, WI 54806
Phone (715) 685-2200

15735 W US Highway 63
Hayward, WI 54843

115 5th Ave N
Hurley, WI 54534
Phone (715) 329-1288

7665 US Highway 2
Iron River, WI 54847
Phone (715) 372-5001

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Social Worker 104100000X 6801100786 MI
Clinical Social Worker 1041C0700X 9470 WI Yes

Addresses

Primary practice location

115 5TH Ave N
Hurley, WI 54534-1208

Mailing address

15735 W US Highway 63
Hayward, WI 54843-6475
Phone (715) 934-0710

Other practice location 1

300 Main St W
Ashland, WI 54806-1639
Phone (715) 685-2200

Other providers in Hurley, WI

All providers in Hurley, WI · Clinical Social Worker in Wisconsin

Sources for this page

Verify at the official NPI Registry.