NPIMap

Organization Active NPI

Wisconsin Lutheran Child & Family Service Inc

  • Clinical Social Worker
  • Hartford, WI
National Provider Identifier
1386713097
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
WISCONSIN LUTHERAN CHILD & FAMILY SERVICE INC
Practice address
112 Peace Lutheran Pkwy
Hartford, WI 53027-1159
Phone
(800) 438-1772
Fax
(262) 293-9737
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Authorized official

Name
Mrs. Linda M Rangel
Title
Insurance Provider Coordinator
Phone
(262) 345-5533

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

112 Peace Lutheran Pkwy
Hartford, WI 53027-1159

Mailing address

W175N11120 Stonewood Dr
Germantown, WI 53022-6511
Phone (800) 438-1772

Other identifiers 2

IdentifierTypeStateIssuer
000084585OtherWIMEDICARE GROUP ID -P TAN
42223600MedicaidWI

Other names 1

  • Christian Family Counseling Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050301000318 WI Part B Supplier - Clinic/Group Practice 0749233898 Receives reassigned benefits from 64 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Appleton, WI; Germantown, WI; Hartford, WI; Jackson, WI; Oak Creek, WI

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1386713097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W175N11120 STONEWOOD DR",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530226511",
            "telephone_number": "800-438-1772",
            "fax_number": "262-293-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 PEACE LUTHERAN PKWY",
            "city": "HARTFORD",
            "state": "WI",
            "postal_code": "530271159",
            "telephone_number": "800-438-1772",
            "fax_number": "262-293-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN LUTHERAN CHILD & FAMILY SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "RANGEL",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "INSURANCE PROVIDER COORDINATOR",
        "authorized_official_telephone_number": "262-345-5533",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID -P TAN",
            "identifier": "000084585",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42223600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christian Family Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hartford, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.