Individual provider Active NPI

Lori Kuntz, LCSW

  • Clinical Social Worker
  • Dodgeville, WI
National Provider Identifier
1316916117
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2962-123 Issued in WI
Practice address
1118 Professional Dr
Dodgeville, WI 53533-1176
Phone
(608) 935-2838
Fax
(608) 935-9227
NPI assigned
Mar 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2962-123 WI Primary

Addresses

Primary practice location

1118 Professional Dr
Dodgeville, WI 53533-1176

Mailing address

1118 Professional Dr
Dodgeville, WI 53533-1176
Phone (608) 935-2838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Uplands Counseling Associates, Inc. CurrentSince Apr 4, 2011 Accepting new patients

Locations

1118 Professional Dr
Dodgeville, WI 53533
Phone (608) 828-3636

6300 Enterprise Ln
Ste 301
Madison, WI 53719
Phone (608) 828-3636

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.

NPI Registry JSON

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391558400000",
    "number": "1316916117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 PROFESSIONAL DR",
            "city": "DODGEVILLE",
            "state": "WI",
            "postal_code": "535331176",
            "telephone_number": "608-935-2838",
            "fax_number": "608-935-9227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 PROFESSIONAL DR",
            "city": "DODGEVILLE",
            "state": "WI",
            "postal_code": "535331176",
            "telephone_number": "608-935-2838",
            "fax_number": "608-935-9227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNTZ",
        "first_name": "LORI",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-15",
        "last_updated": "2014-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2962-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dodgeville, WI

Sources for this page

Verify at the official NPI Registry.