Active NPI
Emily Nelson, CSW
- Social Worker
- Beaver Dam, WI
National Provider Identifier
1255895363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 10132-120
- Practice address
- 809 Park Ave
Beaver Dam, WI 53916-2205 - Phone
- (920) 887-3172
- NPI assigned
- Jan 23, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 10132-120 | WI | Primary |
Addresses
Primary practice location
809 Park Ave
Beaver Dam, WI 53916-2205
Mailing address
809 Park Ave
Beaver Dam, WI 53916-2205
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 |
|---|---|---|---|
| 10132-120 | WI | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lutheran Social Services of Wisconsin and Upper Michigan, Inc. | Social Worker | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Janesville, WI
- NPI 1386719177
Social Worker
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548201600000",
"number": "1255895363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "809 PARK AVE",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539162205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "809 PARK AVE",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539162205",
"telephone_number": "920-887-3172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "EMILY",
"credential": "CSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-23",
"last_updated": "2019-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "10132-120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaver Dam, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.