Shannon Bernice Westphal, MSW, LCSW
Individual provider Active NPI Clinical Social Worker · Hustisford, WI
NPI 1245819200 · NPPES record last updated Nov 16, 2023
Key facts
- NPI
- 1245819200
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 10144-123 (WI)
- Practice address
- 139 North Lake Street
Hustisford, WI 53034-9507 - Phone
- (262) 226-0391
- Fax
- (920) 349-9031
- NPI assigned
- Apr 6, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 31, 2024 through Dec 31, 2026
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 131945 | WI | MD | Social Worker |
| 10144-123 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alarus Home Health LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10144-123 | WI | Yes |
| Social Worker | 104100000X | 131945 | WI |
Addresses
Primary practice location
139 North Lake Street
Hustisford, WI 53034-9507
Mailing address
PO Box 131
Hustisford, WI 53034-0131
Phone (262) 224-7721
Other practice location 1
1622 Chestnut St
West Bend, WI 53095-3014
Phone (262) 306-9800
Other providers in Hustisford, WI
- Karen Anne Knipper
- Paul J Mayer Jr.
- Kari Anne Oshinski
- Rubert Chiropractic Clinic, S.C.
- Paul David Rubert
All providers in Hustisford, WI · Clinical Social Worker in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.