Individual provider Active NPI

Beth Ann Wuerl, LCSW

  • Clinical Social Worker
  • Oconomowoc, WI
National Provider Identifier
1366926396
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8888-123 Issued in WI
Practice address
1230 Corporate Center Dr Ste 100
Oconomowoc, WI 53066-4883
Phone
(262) 189-1191
NPI assigned
Sep 15, 2018
Last updated
Jan 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 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 8888-123 WI Primary

Addresses

Primary practice location

1230 Corporate Center Dr Ste 100
Oconomowoc, WI 53066-4883

Mailing address

515 Glenwood Dr
Hartland, WI 53029-2703
Phone (262) 227-3386

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
I20181205001224 WI Practitioner - Clinical Social Worker 3375887151 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8888-123WIMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.bethannwuerl@149809.advancedmd-direct.com

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, 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": "1536969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1366926396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 GLENWOOD DR",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530292703",
            "telephone_number": "262-227-3386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 CORPORATE CENTER DR STE 100",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530664883",
            "telephone_number": "262-189-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUERL",
        "first_name": "BETH",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-15",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8888-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oconomowoc, WI

Sources for this page

Verify at the official NPI Registry.