Individual provider Active NPI

Lois A Pulvermacher, LCSW

  • Clinical Social Worker
  • Green Bay, WI
National Provider Identifier
1215078662
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7302-123 Issued in WI
Practice address
101 Primrose LN
Green Bay, WI 54311-6882
Phone
(920) 712-4526
Fax
(800) 469-0235
NPI assigned
Feb 9, 2007
Last updated
Nov 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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 7302-123 WI Primary

Addresses

Primary practice location

101 Primrose LN
Green Bay, WI 54311-6882

Mailing address

101 Primrose LN
Green Bay, WI 54311-6882
Phone (920) 712-4526

Other identifiers 2

IdentifierTypeStateIssuer
40918400MedicaidWI
7302-123OtherWILCSW

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
I20110609000485 WI Practitioner - Clinical Social Worker 4486831963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

101 Primrose LN
Green Bay, WI 54311-6882

840 Challenger Dr
Suite 130
Green Bay, WI 54311-8351
Phone (920) 712-4526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7302WIMDProfessional Counselor
7302-123WIMDClinical Social Worker

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, 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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1215078662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PRIMROSE LN",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116882",
            "telephone_number": "920-712-4526",
            "fax_number": "800-469-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PRIMROSE LN",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116882",
            "telephone_number": "920-712-4526",
            "fax_number": "800-469-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PULVERMACHER",
        "first_name": "LOIS",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7302-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40918400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "7302-123",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.