Individual provider Active NPI

Elizabeth Ann Hunkins, LCSW

  • Clinical Social Worker
  • Johnson Creek, WI
National Provider Identifier
1417167586
Registry record updated Feb 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7249-123 Issued in WI
Practice address
429 Conservancy Dr
Johnson Creek, WI 53038-8700
Phone
(920) 342-4105
NPI assigned
May 23, 2007
Last updated
Feb 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2026

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 7249-123 WI Primary

Addresses

Primary practice location

429 Conservancy Dr
Johnson Creek, WI 53038-8700

Mailing address

429 Conservancy Dr
Johnson Creek, WI 53038-8700
Phone (920) 342-4105

Other identifiers 1

IdentifierTypeStateIssuer
43719100MedicaidWI

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
I20070712000416 WI Practitioner - Clinical Social Worker 8426158973 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fort Healthcare IncGroup PAC ID 0840189718, 159 clinicians

Practice addresses (Care Compare)

611 E Sherman Ave
Fort Atkinson, WI 53538-1960
Phone (920) 568-5000

611 Sherman Ave E
Fort Atkinson, WI 53538-1960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7249-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Healthcare Inc CurrentSince Jun 1, 2023 Accepting new patients
Fort Healthcare Inc Clinical Current Accepting new patients
Stepping Stones Psychotherapy, LLC Clinical Current Accepting new patients
Encompass-Effective Mental Health Services, Inc Clinical PastSince Apr 18, 2025 Accepting new patients

Locations

500 McMillen St
Fort Atkinson, WI 53538
Phone (920) 563-5571

611 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 563-6667

Interoperability endpoints

  • Direct secure messaging: elizabeth.hunkins@direct.forthc.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/8F7ruIta-JA7ecm4ommy-Q50dF1FkFe4/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771804800000",
    "number": "1417167586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 CONSERVANCY DR",
            "city": "JOHNSON CREEK",
            "state": "WI",
            "postal_code": "530388700",
            "telephone_number": "920-342-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 CONSERVANCY DR",
            "city": "JOHNSON CREEK",
            "state": "WI",
            "postal_code": "530388700",
            "telephone_number": "920-342-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNKINS",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7249-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43719100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson Creek, WI

Sources for this page

Verify at the official NPI Registry.