Travis H Vandebrown, MSW, LCSW, CSAC, ICS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11401-123 Issued in WI

Practice address

333 E Washington St Ste 2100
West Bend, WI 53095-2503

Phone

(262) 335-4583

NPI assigned

Oct 9, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Travis H Brown Former name

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

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Washington County WisconsinGroup PAC ID 1951202142, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Washington County Wisconsin

  dba Washington County Human Services Mental Health Center

  • Community/Behavioral Health Agency
  • West Bend, WI
  • NPI 1609801778

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD
• West Grove Clinic, SC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wauwatosa, WI
  • NPI 1518167477
  NPD (past)

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1245601772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E WASHINGTON ST STE 2100",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530952503",
            "telephone_number": "262-335-4583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E WASHINGTON ST STE 2100",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530952503",
            "telephone_number": "262-335-4583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEBROWN",
        "first_name": "TRAVIS",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW, CSAC, ICS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-09",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "132330-121",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16017-132",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11401-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100050428",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRAVIS",
            "last_name": "BROWN",
            "middle_name": "H",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paul D Tyberg, DDS
• Tyler Home Care, LLC
• Matthew J Uecker, PT
• United Care Homes of Wisconsin LLC
• Emily Utic
• Deborah Lewis Vanderkinter, LPC, SAC
• Anne Vechinski, PHARMD
• Kaiea La'Iku Vera, ATC
• Nipun Gupta Verma, M.D.
• Kaylin Visauer, APNP

• Clinical Social Worker in West Bend, WI
• Providers in West Bend, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.