Active NPI
Catherine M Connelly, LCSW
- Clinical Social Worker
- Wauwatosa, WI
National Provider Identifier
1194923219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1972-123
- Practice address
- 1220 Dewey Ave
BLDG 1
Wauwatosa, WI 53213-2504 - Phone
- (414) 454-6506
- Fax
- (414) 454-6450
- NPI assigned
- Jul 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 1972-123 | WI | Primary |
Addresses
Primary practice location
1220 Dewey Ave
BLDG 1
Wauwatosa, WI 53213-2504
Mailing address
1220 Dewey Ave
BLDG 1
Wauwatosa, WI 53213-2504
Phone (414) 454-6506
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39723400 | Medicaid | WI |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1972-123 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Health Care Metro, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1861447179
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184025600000",
"number": "1194923219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1220 DEWEY AVE",
"address_2": "BLDG 1",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532132504",
"telephone_number": "414-454-6506",
"fax_number": "414-454-6450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 DEWEY AVE",
"address_2": "BLDG 1",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532132504",
"telephone_number": "414-454-6506",
"fax_number": "414-454-6450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNELLY",
"first_name": "CATHERINE",
"middle_name": "M",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-10",
"last_updated": "2007-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "1972-123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39723400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wauwatosa, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.