Individual provider Active NPI

Paul David Workman

  • Professional Counselor
  • Minong, WI
National Provider Identifier
1497274591
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8268-125 Issued in WI
Practice address
600 W Shell Creek Rd
Minong, WI 54859-9302
Phone
(715) 466-2201
NPI assigned
Sep 11, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3651-226 WI
Professional Counselor 101YP2500X 8268-125 WI Primary

Addresses

Primary practice location

600 W Shell Creek Rd
Minong, WI 54859-9302

Mailing address

13380 W Trepania Rd
Hayward, WI 54843-2186
Phone (715) 638-5105

Other practice location 1

13380 W Trepania Rd
Hayward, WI 54843-2186
Phone (715) 638-5105

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
I20231228000725 WI Practitioner - Mental Health Counselor 5092165423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

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
3651-226WIMDProfessional Counselor
8268-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Lakes Community Health Center, Inc CurrentSince Jan 1, 2024 Accepting new patients
The Lakes Community Health Center, Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

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

15735 W US Highway 63
Hayward, WI 54843

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

600 W Shell Creek Rd
Minong, WI 54859
Phone (715) 364-8565

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": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497274591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13380 W TREPANIA RD",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548432186",
            "telephone_number": "715-638-5105",
            "fax_number": "715-634-6107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W SHELL CREEK RD",
            "city": "MINONG",
            "state": "WI",
            "postal_code": "548599302",
            "telephone_number": "715-466-2201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13380 W Trepania Rd",
            "address_purpose": "LOCATION",
            "city": "Hayward",
            "state": "WI",
            "postal_code": "548432186",
            "country_code": "US",
            "telephone_number": "715-638-5105",
            "fax_number": "715-634-6107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WORKMAN",
        "first_name": "PAUL",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-11",
        "last_updated": "2022-07-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3651-226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8268-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minong, WI

Sources for this page

Verify at the official NPI Registry.