Active NPI
Peter T Laubach, LCSW, CADC
- Social Worker
- Baraboo, WI
National Provider Identifier
1316953540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 885-123
- Practice address
- 1002 Lincoln Ave
Baraboo, WI 53913-1808 - Phone
- (608) 356-9055
- Fax
- (608) 356-5447
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 885-123 | WI | |
| Social Worker | 104100000X | 885-123 | WI | Primary |
Addresses
Primary practice location
1002 Lincoln Ave
Baraboo, WI 53913-1808
Mailing address
1002 Lincoln Ave
Baraboo, WI 53913-1808
Phone (608) 356-9055
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39227400 | Medicaid | WI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 885-123 | WI | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capitol Associates, SC | Social Worker | Past | Accepting new patients |
| Samaritan Counseling Center | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Adult Mental Health Clinic/Center
- Monona, WI
- NPI 1205077427
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432166400000",
"number": "1316953540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1002 LINCOLN AVE",
"city": "BARABOO",
"state": "WI",
"postal_code": "539131808",
"telephone_number": "608-356-9055",
"fax_number": "608-356-5447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 LINCOLN AVE",
"city": "BARABOO",
"state": "WI",
"postal_code": "539131808",
"telephone_number": "608-356-9055",
"fax_number": "608-356-5447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAUBACH",
"first_name": "PETER",
"middle_name": "T",
"credential": "LCSW, CADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2015-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "885-123",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "885-123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39227400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baraboo, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.