Janis Marie Southworth, MA PC-TC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1773-226 Issued in WI

Practice address

136 W Broadway Ave
Medford, WI 54451-1757

Phone

(715) 748-4535

Fax

(715) 748-0627

NPI assigned

Aug 20, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aspirus Rhinelander and Tomahawk Hospitals and Clinics, Inc.Group PAC ID 9335059856, shared by 17 NPIs, 566 clinicians

Human Services Board Serving North Central Health Care FacilityGroup PAC ID 4385617786, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Human Services Board Serving North Central Health Care Facility

  • Multi-Specialty Clinic/Center
  • Wausau, WI
  • NPI 1205944543
  Medicare reassignment Care Compare group NPD
• Human Services Board Serving North Central Health Care Facility

  • Psychiatric Hospital
  • Wausau, WI
  • NPI 1932714292
  NPD
• Human Services Board Serving North Central Heatlh Care Facility

  • Multi-Specialty Clinic/Center
  • Wausau, WI
  • NPI 1821106162
  NPD (past)
• North Central Counseling Center, Inc.

  • Professional Counselor
  • Stetsonville, WI
  • NPI 1891863494
  NPD (past)

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1235562737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 W BROADWAY AVE",
            "address_2": "P O BOX 297",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511757",
            "telephone_number": "715-748-4535",
            "fax_number": "715-748-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 W BROADWAY AVE",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511757",
            "telephone_number": "715-748-4535",
            "fax_number": "715-748-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHWORTH",
        "first_name": "JANIS",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MA PC-TC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "1773-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Troy D Sennholz, MD
• Jeremy F Sherman, PT
• Priya Sinha
• Julia Ann Smith
• Jordyn L Soppa
• Laura M Sova, APNP
• Jacki J Stelzel, NP
• Rebecca Lee Stieber, PHARMD
• Sara Jayne Stieber, PA-C
• Dale J Strama, DC

• Professional Counselor in Medford, WI
• Providers in Medford, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.