Active NPI
Debra Reid
- Clinical Social Worker
- Hales Corners, WI
National Provider Identifier
1548920580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 12300 W Janesville Rd
Hales Corners, WI 53130-2350 - Phone
- (414) 529-6700
- NPI assigned
- Dec 17, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 123-2471 | WI | |
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
12300 W Janesville Rd
Hales Corners, WI 53130-2350
Mailing address
12300 W Janesville Rd
Hales Corners, WI 53130-2350
Phone (414) 529-6700
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 |
|---|---|---|---|
| 123-2471 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639699200000",
"number": "1548920580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12300 W JANESVILLE RD",
"city": "HALES CORNERS",
"state": "WI",
"postal_code": "531302350",
"telephone_number": "414-529-6700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12300 W JANESVILLE RD",
"city": "HALES CORNERS",
"state": "WI",
"postal_code": "531302350",
"telephone_number": "414-529-6700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REID",
"first_name": "DEBRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-17",
"last_updated": "2021-12-17",
"certification_date": "2021-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "123-2471",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hales Corners, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.