Individual provider Active NPI

Jolene Rose Blaha, LCSW

  • Clinical Social Worker
  • Juneau, WI
National Provider Identifier
1194569384
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12857-123 Issued in WI
Practice address
199 County Road DF FL 3
Juneau, WI 53039-9512
Phone
(920) 386-3500
Fax
(920) 386-4564
NPI assigned
Jun 21, 2024
Last updated
Apr 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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 12857-123 WI Primary

Addresses

Primary practice location

199 County Road DF FL 3
Juneau, WI 53039-9512

Mailing address

590 River Rd Apt 5
Columbus, WI 53925-1722
Phone (920) 350-2866

Other names 1

  • Jolene Rose Obrion 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
I20260417001219 WI Practitioner - Clinical Social Worker 4688140544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of DodgeGroup PAC ID 2466475587, 10 clinicians

Practice addresses (Care Compare)

199 County Rd DF
Suite 3
Juneau, WI 53039-9512
Phone (920) 386-4094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12857-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Dodge CurrentSince Mar 24, 2026 Accepting new patients
County of Dodge PastSince Mar 24, 2026 Accepting new patients

Locations

199 County Road DF
#3
Juneau, WI 53039
Phone (920) 386-4094

199 County Road DF
Fl 3
Juneau, WI 53039
Phone (920) 386-4094

199 Cty Df
Juneau, WI 53039
Phone (262) 735-8005

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1718928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1194569384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 RIVER RD APT 5",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539251722",
            "telephone_number": "920-350-2866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 COUNTY ROAD DF FL 3",
            "city": "JUNEAU",
            "state": "WI",
            "postal_code": "530399512",
            "telephone_number": "920-386-3500",
            "fax_number": "920-386-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAHA",
        "first_name": "JOLENE",
        "middle_name": "ROSE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-21",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "12857-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOLENE",
            "last_name": "OBRION",
            "middle_name": "ROSE",
            "credential": "APSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Juneau, WI

Sources for this page

Verify at the official NPI Registry.