Active NPI
Emily Worth
- Mental Health Counselor
- Beaver Dam, WI
National Provider Identifier
1467051706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1426 Hiawatha Dr
Beaver Dam, WI 53916-1042 - Phone
- (920) 210-9290
- NPI assigned
- Oct 19, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 2508-125 | WI | |
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1426 Hiawatha Dr
Beaver Dam, WI 53916-1042
Mailing address
1426 Hiawatha Dr
Beaver Dam, WI 53916-1042
Phone (920) 210-9290
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2508-125 | WI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603065600000",
"number": "1467051706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1426 HIAWATHA DR",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539161042",
"telephone_number": "920-210-9290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1426 HIAWATHA DR",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539161042",
"telephone_number": "920-210-9290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WORTH",
"first_name": "EMILY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-19",
"last_updated": "2020-10-19",
"certification_date": "2020-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WI",
"license": "2508-125",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaver Dam, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.