Individual provider Active NPI

Alesia Bates, MSW, LCSW

  • Clinical Social Worker
  • Green Bay, WI
National Provider Identifier
1376964320
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8477-123 Issued in WI
Practice address
2851 University Ave
Green Bay, WI 54311-5855
Phone
(920) 431-2500
NPI assigned
Dec 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 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 8477-123 WI Primary

Addresses

Primary practice location

2851 University Ave
Green Bay, WI 54311-5855

Mailing address

2851 University Ave
Green Bay, WI 54311-5855
Phone (920) 431-2500

Other practice location 1

3001 Green Bay Rd # 18B
North Chicago, IL 60064-3048
Phone (847) 688-1900

Other names 1

  • Alesia Behnke Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8477-123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1376964320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 UNIVERSITY AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115855",
            "telephone_number": "920-431-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2851 UNIVERSITY AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115855",
            "telephone_number": "920-431-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3001 Green Bay Rd # 18B",
            "address_purpose": "LOCATION",
            "city": "North Chicago",
            "state": "IL",
            "postal_code": "600643048",
            "country_code": "US",
            "telephone_number": "847-688-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BATES",
        "first_name": "ALESIA",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-18",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8477-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALESIA",
            "last_name": "BEHNKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.