Patricia A Desjardin, MSW LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1173123 Issued in WI

Practice address

711 N Bridge Street
Room 122
Chippewa Falls, WI 54729-1876

Phone

(715) 726-7788

Fax

(715) 726-4560

NPI assigned

Nov 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396819793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 N BRIDGE STREET",
            "address_2": "ROOM 122",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547291876",
            "telephone_number": "715-726-7788",
            "fax_number": "715-726-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N BRIDGE STREET",
            "address_2": "ROOM 122",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547291876",
            "telephone_number": "715-726-7788",
            "fax_number": "715-726-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESJARDIN",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "credential": "MSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "1173123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39637400",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECURITY HEALTH",
            "identifier": "54173",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Chippewa Falls, WI
• Providers in Chippewa Falls, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.