Lutheran Social Services of Upper Michigan

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

15448-130 Issued in WI

Legal business name

LUTHERAN SOCIAL SERVICES OF UPPER MICHIGAN

Practice address

131 S,. Main Street
Fond Du Lac, WI 54935

Phone

(920) 730-1349

Fax

(920) 724-2824

NPI assigned

Sep 28, 2009

Last updated

Sep 28, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Vicky Ann Thull, SAC-IT

Title

Substance Abuse Counselor-I T

Phone

(920) 924-5222

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kaylin Jayne Reeb, CAPSW

  • Clinical Social Worker
  • Fond Du Lac, WI
  • NPI 1962834887
  NPD (past)
• Alisha Bisbee, LCMHCA

  • Professional Counselor
  • Oak Ridge, NC
  • NPI 1477959468
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254096000000",
    "number": "1558695304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 B N. RICHMOND STREET",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111148",
            "telephone_number": "920-730-1349",
            "fax_number": "920-724-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 S,. MAIN STREET",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "54935",
            "telephone_number": "920-730-1349",
            "fax_number": "920-724-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN SOCIAL SERVICES OF UPPER MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-28",
        "last_updated": "2009-09-28",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "VICKY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "SUBSTANCE ABUSE COUNSELOR-I T",
        "authorized_official_telephone_number": "920-924-5222",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "SAC-IT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "15448-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lumos
• Jack Lund
• Sheri Lund
• Breanne M Lundt
• Jackie Luthardt, MD
• Luxottica Retail North America Inc (Lenscrafters #1785)
• Michael Anthony Lynch, PSY.D.
• Elizabeth Anne Machi, DDS
• Kassianna G Madison
• Michael R Magoline, M.D.

• Community/Behavioral Health Agency in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Community/Behavioral Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.