Individual provider Active NPI

Paul Nelson Roadt, LCSW, CSAC

  • Clinical Social Worker
  • Eau Claire, WI
National Provider Identifier
1376998922
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8702-123 Issued in WI
Practice address
1221 Whipple St
Eau Claire, WI 54703
Phone
(715) 838-5222
NPI assigned
May 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15905-132 WI
Clinical Social Worker 1041C0700X 8702-123 WI Primary

Addresses

Primary practice location

1221 Whipple St
Eau Claire, WI 54703

Mailing address

PO Box 1510
Eau Claire, WI 54702-1510
Phone (715) 838-5222

Other practice location 1

1400 Bellinger St
Eau Claire, WI 54703-5222
Phone (715) 838-5222

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
I20160525000741 WI Practitioner - Clinical Social Worker 9739478173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
22 A Day Counseling L.L.C.Group PAC ID 3173958675, 2 clinicians

Practice addresses (Care Compare)

2211 E Clairemont Ave
Suite 2
Eau Claire, WI 54701-4921
Phone (715) 598-1865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15905-132WIMDAddiction (Substance Use Disorder) Counselor
8702-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
22 A Day Counseling L.L.C. Clinical CurrentSince May 29, 2019 Accepting new patients

Locations

2211 E Clairemont Ave
Ste 2
Eau Claire, WI 54701
Phone (715) 598-1865

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": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1376998922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547021510",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 WHIPPLE ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "54703",
            "telephone_number": "715-838-5222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Bellinger St",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547035222",
            "country_code": "US",
            "telephone_number": "715-838-5222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROADT",
        "first_name": "PAUL",
        "middle_name": "NELSON",
        "credential": "LCSW, CSAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-02",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15905-132",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8702-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.