Active NPI
Layla Michelle Wirtz, LCSW
- Clinical Social Worker
- Milwaukee, WI
National Provider Identifier
1396588554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11800-123
- Practice address
- 2979 N 74TH St
Milwaukee, WI 53210-1013 - Phone
- (508) 873-8421
- NPI assigned
- Jun 17, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 11591-123 | WI | |
| Clinical Social Worker | 1041C0700X | 11800-123 | WI | Primary |
Addresses
Primary practice location
2979 N 74TH St
Milwaukee, WI 53210-1013
Mailing address
2979 N 74TH St
Milwaukee, WI 53210-1013
Phone (508) 873-8421
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11591-123 | WI | MD | Clinical Social Worker |
| 11800-123 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719273600000",
"number": "1396588554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2979 N 74TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532101013",
"telephone_number": "508-873-8421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2979 N 74TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532101013",
"telephone_number": "508-873-8421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIRTZ",
"first_name": "LAYLA",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-17",
"last_updated": "2024-06-25",
"certification_date": "2024-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "11591-123",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "11800-123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.