Individual provider Active NPI

Kinsey Beth Pierre, MSW, LCSW

  • Clinical Social Worker
  • Appleton, WI
National Provider Identifier
1346735891
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9426-123 Issued in WI
Practice address
119 N McCarthy Rd Ste P
Appleton, WI 54913-9112
Phone
(920) 903-1060
Fax
(920) 903-1164
NPI assigned
Jun 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 131062-121 WI
Clinical Social Worker 1041C0700X 9426-123 WI Primary

Addresses

Primary practice location

119 N McCarthy Rd Ste P
Appleton, WI 54913-9112

Mailing address

119 N McCarthy Rd Ste P
Appleton, WI 54913-9112
Phone (920) 903-1060

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
I20200521001252 WI Practitioner - Clinical Social Worker 7911338207 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
131062-121WIMDClinical Social Worker
9426-123WIMDClinical Social Worker
9426WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
US 2 Behavioral Health Care Inc CurrentSince May 15, 2020 Accepting new patients

Locations

5750 W Grande Market Dr
#A
Appleton, WI 54913
Phone (920) 903-1060

4650 W Spencer St
Appleton, WI 54914
Phone (920) 903-1060

119 N McCarthy Rd
Ste P
Appleton, WI 54913
Phone (920) 903-1060

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": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1346735891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 N MCCARTHY RD STE P",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139112",
            "telephone_number": "920-903-1060",
            "fax_number": "920-903-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 N MCCARTHY RD STE P",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139112",
            "telephone_number": "920-903-1060",
            "fax_number": "920-903-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERRE",
        "first_name": "KINSEY",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "131062-121",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9426-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.