Individual provider Active NPI

Denise Anne Cassidy, LCSW

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1306019682
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1103-123 Issued in WI
Practice address
3801 N 88TH St
Milwaukee, WI 53222-2706
Phone
(414) 760-8073
Fax
(414) 466-0730
NPI assigned
Apr 8, 2008
Sex
Female
Sole proprietor
No

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

LicenseStateTypeSpecialty
1103-123WIMDClinical Social Worker

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1103-123 WI Primary

Addresses

NPPES NPI Registry

Primary practice location

3801 N 88TH St
Milwaukee, WI 53222-2706

Mailing address

3801 N 88TH St
Milwaukee, WI 53222-2706
Phone (414) 760-8073

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
39532600MedicaidWI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 8, 2008.

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1306019682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 N 88TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532222706",
            "telephone_number": "414-760-8073",
            "fax_number": "414-466-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 N 88TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532222706",
            "telephone_number": "414-760-8073",
            "fax_number": "414-466-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "DENISE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "1103-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39532600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.