Individual provider Active NPI

Sean M. Inderbitzen, LCSW

  • Clinical Social Worker
  • Rice Lake, WI
National Provider Identifier
1487219838
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9894 Issued in WI
Practice address
1051 West Ave
Rice Lake, WI 54868-4425
Phone
(715) 736-5437
NPI assigned
May 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 131408-121 WI
Social Worker 104100000X 131408 WI
Clinical Social Worker 1041C0700X 9894 WI Primary

Addresses

Primary practice location

1051 West Ave
Rice Lake, WI 54868-4425

Mailing address

15735 W US Highway 63
Hayward, WI 54843-6475
Phone (715) 634-2541

Other identifiers 1

IdentifierTypeStateIssuer
100087784MedicaidWI

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
I20220706002755 WI Practitioner - Clinical Social Worker 8729468954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Lakes Community Health Center IncGroup PAC ID 0840366654, 104 clinicians

Practice addresses (Care Compare)

7665 US Hwy 2
Iron River, WI 54847-4690
Phone (715) 372-5001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
131408WIMDSocial Worker
131408-121WIMDSocial Worker
9894WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Lakes Community Health Center, Inc CurrentSince Apr 18, 2022 Accepting new patients
The Lakes Community Health Center, Inc CurrentSince Apr 18, 2022 Accepting new patients
The Lakes Community Health Center, Inc Past Accepting new patients
Marriage & Family Health Services, LTD. Clinical Past Accepting new patients

Locations

300 Main St W
Ashland, WI 54806
Phone (715) 685-2200

15735 W US Highway 63
Hayward, WI 54843

15954 Rivers Edge Dr
Hayward, WI 54843

7665 US Highway 2
Iron River, WI 54847
Phone (715) 372-5001

1051 West Ave
Rice Lake, WI 54868
Phone (715) 719-0662

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": "1556668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1487219838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15735 W US HIGHWAY 63",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548436475",
            "telephone_number": "715-634-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 WEST AVE",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548684425",
            "telephone_number": "715-736-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDERBITZEN",
        "first_name": "SEAN",
        "middle_name": "M.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-01",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "131408-121",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "131408",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100087784",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rice Lake, WI

Sources for this page

Verify at the official NPI Registry.