Kristin Elizabeth Wilson, CAPSW DSPS 121-1146

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

121-1146 Issued in WI

Practice address

1532 W Broadway Ste 202
Monona, WI 53713-1828

Phone

(608) 661-2829

Fax

(608) 661-0907

NPI assigned

Sep 27, 2022

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

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake City Counseling, LLCGroup PAC ID 6103995477, 6 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.

• Lake City Counseling, LLC

  • Counselor
  • Monona, WI
  • NPI 1679755987
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1664236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1285358812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 W BROADWAY STE 202",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537131828",
            "telephone_number": "608-661-2829",
            "fax_number": "608-661-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 W BROADWAY STE 202",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537131828",
            "telephone_number": "608-661-2829",
            "fax_number": "608-661-0907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2829 Royal Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Monona",
            "state": "WI",
            "postal_code": "537131535",
            "country_code": "US",
            "telephone_number": "608-661-2829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6534 Shower Rd",
            "address_purpose": "LOCATION",
            "city": "Mazomanie",
            "state": "WI",
            "postal_code": "535609601",
            "country_code": "US",
            "telephone_number": "608-535-7351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KRISTIN",
        "middle_name": "ELIZABETH",
        "credential": "CAPSW DSPS 121-1146",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-27",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "121-1146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn B White, PHD
• Beth S Whittemore, MSW
• William Howard Wilcox, D.D.S.
• Karen Elizabeth Willems
• Michael Duane Williams, MD
• Rachel Winograd, RN
• Gregory Wipperfurth, D.D.S.
• Chelsea Wirth, PHARMD
• Gerald Wistein, ICS, CSAC, MSW
• Judson A Wong, PT

• Clinical Social Worker in Monona, WI
• Providers in Monona, 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 28, 2022; 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.