Individual provider Active NPI

Christine Mari Wilford, LICSW

  • Clinical Social Worker
  • West Allis, WI
National Provider Identifier
1538418116
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1933-123 Issued in WI
Practice address
2044 S 96TH Street
West Allis, WI 53227
Phone
(414) 698-6104
NPI assigned
Aug 29, 2012
Last updated
Dec 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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 1933-123 WI Primary

Addresses

Primary practice location

2044 S 96TH Street
West Allis, WI 53227

Mailing address

10408 55TH Ave
Pleasant Prairie, WI 53158-3401
Phone (414) 698-6106

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
I20260116002887 WI Practitioner - Clinical Social Worker 3173000403 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Wisconsin School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wi SHMH SCGroup PAC ID 7012455462, 9 clinicians

Practice addresses (Care Compare)

18740 W Bluemound Rd
Brookfield, WI 53045-2936
Phone (773) 332-7539

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1933-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ganesha Institute of Neurology and Psychiatry SC Clinical CurrentSince Jan 1, 2026 Accepting new patients
Ganesha Institute of Neurology and Psychiatry SC Clinical CurrentSince Jan 1, 2026 Accepting new patients
Wi SHMH SC CurrentSince Apr 13, 2026 Accepting new patients

Locations

18740 W Bluemound Rd
Brookfield, WI 53045
Phone (262) 782-0230

4600 Green Bay Rd
Kenosha, WI 53144
Phone (847) 816-6335

Organizations & group practices 3

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": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1538418116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10408 55TH AVE",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531583401",
            "telephone_number": "414-698-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2044 S 96TH STREET",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "53227",
            "telephone_number": "414-698-6104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILFORD",
        "first_name": "CHRISTINE",
        "middle_name": "MARI",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "1933-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.