Individual provider Active NPI

Michael H Winius, MSW , LCSW

  • Clinical Social Worker
  • Appleton, ID
National Provider Identifier
1346393287
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6699 123 Issued in WI
Practice address
477 S Nicolet Road
Appleton, ID 54914-8270
Phone
(920) 882-6610
Fax
(920) 882-6611
NPI assigned
Jan 22, 2007
Last updated
Jun 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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 6699 123 WI Primary

Addresses

Primary practice location

477 S Nicolet Road
Appleton, ID 54914-8270

Mailing address

477 S Nicolet Road
Appleton, ID 54914-8270
Phone (920) 882-6610

Other identifiers 1

IdentifierTypeStateIssuer
40920800MedicaidWI

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
I20091029000318 WI Practitioner - Clinical Social Worker 1951448653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JB Behavioral Health, LLCGroup PAC ID 7113390972, 8 clinicians

Practice addresses (Care Compare)

301 N Broadway
Suite 110
De Pere, WI 54115-2571
Phone (920) 425-4900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6699 123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
JB Behavioral Health, LLC CurrentSince Jul 1, 2023 Accepting new patients
Appleton Counseling Management LLC PastSince Jul 24, 2022 Accepting new patients
St Clare Memorial Hospital, Inc Past Accepting new patients
Appleton Psychiatric & Counseling Center Clinical PastSince Aug 4, 2015 Accepting new patients

Locations

101 W Edison Ave
Ste 113
Appleton, WI 54915
Phone (920) 370-7167

301 N Broadway
Ste 110
De Pere, WI 54115
Phone (920) 338-2855

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1346393287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 S NICOLET ROAD",
            "city": "APPLETON",
            "state": "ID",
            "postal_code": "549148270",
            "telephone_number": "920-882-6610",
            "fax_number": "920-882-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 S NICOLET ROAD",
            "city": "APPLETON",
            "state": "ID",
            "postal_code": "549148270",
            "telephone_number": "920-882-6610",
            "fax_number": "920-882-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINIUS",
        "first_name": "MICHAEL",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "MSW , LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "6699 123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40920800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.