Individual provider Active NPI

Rosonna Sue Comers, LCSW CADCIII

  • Clinical Social Worker
  • Fond Du Lac, WI
National Provider Identifier
1467591131
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7003123 Issued in WI
Practice address
N6687 Wrightway Dr
Ste D
Fond Du Lac, WI 54937
Phone
(920) 929-9140
Fax
(920) 929-9142
NPI assigned
Feb 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 7003123 WI Primary

Addresses

Primary practice location

N6687 Wrightway Dr
Ste D
Fond Du Lac, WI 54937

Mailing address

1512 Oshkosh Ave
Oshkosh, WI 54902
Phone (920) 410-6047

Other identifiers 1

IdentifierTypeStateIssuer
39386100MedicaidWI

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
I20220126000877 WI Practitioner - Clinical Social Worker 1355582016 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7003123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrity Counseling, LLC CurrentSince Nov 1, 2024 Accepting new patients
Integrated Counseling Center LLC Clinical Past Accepting new patients

Locations

1011 N Lynndale Dr
Ste 2D
Appleton, WI 54914
Phone (920) 385-1420

100 N Main St
Ste 103
Oshkosh, WI 54901
Phone (920) 385-1420

Organizations & group practices 2

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467591131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 OSHKOSH AVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "54902",
            "telephone_number": "920-410-6047",
            "fax_number": "920-929-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N6687 WRIGHTWAY DR",
            "address_2": "STE D",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "54937",
            "telephone_number": "920-929-9140",
            "fax_number": "920-929-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMERS",
        "first_name": "ROSONNA",
        "middle_name": "SUE",
        "credential": "LCSW CADCIII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7003123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39386100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

Verify at the official NPI Registry.