Individual provider Active NPI

Paul Charles Brown, LCSW, NCC

  • Clinical Social Worker
  • La Crosse, WI
National Provider Identifier
1386825867
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2791-123 Issued in WI
Practice address
201 Main St Ste 500
La Crosse, WI 54601-0716
Phone
(608) 606-6725
NPI assigned
Nov 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 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 2791-123 WI Primary

Addresses

Primary practice location

201 Main St Ste 500
La Crosse, WI 54601-0716

Mailing address

201 Main St Ste 500
La Crosse, WI 54601-0716
Phone (608) 606-6725

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
I20211103001755 WI Practitioner - Clinical Social Worker 7810385218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates Counseling Wi SCGroup PAC ID 1052729464, 108 clinicians

Practice addresses (Care Compare)

201 Main St
Suite 500
La Crosse, WI 54601-0716
Phone (608) 668-4005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2791-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Dec 1, 2021 Accepting new patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Dec 1, 2021 Accepting new patients

Locations

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

2501 Hanley Rd
Ste 201
Hudson, WI 54016
Phone (534) 544-5247

201 Main St
Ste 500
La Crosse, WI 54601
Phone (608) 668-4005

Organizations & group practices 2

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": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1386825867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MAIN ST STE 500",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546010716",
            "telephone_number": "608-606-6725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MAIN ST STE 500",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546010716",
            "telephone_number": "608-606-6725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "PAUL",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "LCSW, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-26",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2791-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.