Active NPI
Charles R Michels, LCSW
- Social Worker
- Minocqua, WI
National Provider Identifier
1548371164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 666
- Practice address
- 9792 Hwy 70 W
Minocqua, WI 54548 - Phone
- (715) 356-1793
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 666 | WI | Primary |
Addresses
Primary practice location
9792 Hwy 70 W
Minocqua, WI 54548
Mailing address
9612 Manitou Park Dr
Minocqua, WI 54548-9302
Phone (715) 356-2186
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39504900 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 666 | WI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197331200000",
"number": "1548371164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9612 MANITOU PARK DR",
"city": "MINOCQUA",
"state": "WI",
"postal_code": "545489302",
"telephone_number": "715-356-2186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9792 HWY 70 W",
"city": "MINOCQUA",
"state": "WI",
"postal_code": "54548",
"telephone_number": "715-356-1793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHELS",
"first_name": "CHARLES",
"middle_name": "R",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "666",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39504900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minocqua, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.