Individual provider Active NPI

Deanna Jeanne Brown, LCSW

  • Clinical Social Worker
  • Appleton, WI
National Provider Identifier
1346265519
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801093118 Issued in MI
Practice address
1835 E Edgewood Dr Ste 105-534
Appleton, WI 54913-9407
Phone
(715) 889-6452
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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 6801093118 MI Primary

Addresses

Primary practice location

1835 E Edgewood Dr Ste 105-534
Appleton, WI 54913-9407

Mailing address

1835 E Edgewood Dr Ste 105-534
Appleton, WI 54913-9407
Phone (715) 889-0784

Other practice location 1

715 Pyle Dr
Kingsford, MI 49802-4456
Phone (906) 774-0522

Other names 1

  • Deanna Jeanne Vaughn Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160608000105 WI Practitioner - Clinical Social Worker 1052546421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Michigan State University College of Human Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1835 E Edgewood Dr
Suite 105 534
Appleton, WI 54913-9407
Phone (715) 889-0784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801093118MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northwoods Therapist LLC Clinical CurrentSince May 26, 2022 Accepting new patients
County of Marinette CurrentSince May 2, 2016 Accepting new patients
County of Marinette CurrentSince May 2, 2016 Accepting new patients

Locations

1835 E Edgewood Dr
Ste 105534
Appleton, WI 54913
Phone (715) 889-0784

2500 Hall Ave
Ste A
Marinette, WI 54143
Phone (715) 732-7760

Organizations & group practices 3

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1346265519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 E EDGEWOOD DR STE 105-534",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139407",
            "telephone_number": "715-889-0784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 E EDGEWOOD DR STE 105-534",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139407",
            "telephone_number": "715-889-6452"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 Pyle Dr",
            "address_purpose": "LOCATION",
            "city": "Kingsford",
            "state": "MI",
            "postal_code": "498024456",
            "country_code": "US",
            "telephone_number": "906-774-0522",
            "fax_number": "906-774-1570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DEANNA",
        "middle_name": "JEANNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANNA",
            "last_name": "VAUGHN",
            "middle_name": "JEANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.