Individual provider Active NPI

Gabrielle Cassandra Jochman, LCSW

  • Clinical Social Worker
  • Appleton, WI
National Provider Identifier
1407486541
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9881-123 Issued in WI
Practice address
2500 E Enterprise Ave Ste B
Appleton, WI 54913-8556
Phone
(920) 416-8577
Fax
(920) 416-8581
NPI assigned
Jan 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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 9881-123 WI Primary

Addresses

Primary practice location

2500 E Enterprise Ave Ste B
Appleton, WI 54913-8556

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (651) 628-9566

Other names 1

  • Gabrielle Cassandra Samson Jochman Other name

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
I20220315000805 WI Practitioner - Clinical Social Worker 2567857303 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2500 E Enterprise Ave
Suite B
Appleton, WI 54913-8556
Phone (920) 416-8577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9881-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Psychiatric Center Inc Current Accepting new patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Nov 11, 2024 Accepting new patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Nov 11, 2024 Accepting new patients
Bellin Psychiatric Center Inc. Clinical CurrentSince Feb 21, 2022 Accepting new patients

Locations

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

2500 E Enterprise Ave
Ste B
Appleton, WI 54913
Phone (920) 416-8577

301 Saint Joseph St
Green Bay, WI 54301
Phone (920) 430-3630

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

Organizations & group practices 4

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": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1407486541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E ENTERPRISE AVE STE B",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138556",
            "telephone_number": "920-416-8577",
            "fax_number": "920-416-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOCHMAN",
        "first_name": "GABRIELLE",
        "middle_name": "CASSANDRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-16",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9881-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GABRIELLE",
            "last_name": "JOCHMAN",
            "middle_name": "CASSANDRA SAMSON",
            "credential": "SW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.