Active NPI
Dennis Keith Wolf, LCSW
- Clinical Social Worker
- Hales Corners, WI
National Provider Identifier
1588713705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2698123LCSW
- Practice address
- 12065 W Janesville Road
Hales Corners, WI 53130 - Phone
- (414) 425-2655
- NPI assigned
- Jan 9, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2698123LCSW | WI | Primary |
Addresses
Primary practice location
12065 W Janesville Road
Hales Corners, WI 53130
Mailing address
19090 Still Point Trail
Brookfield, WI 53045
Phone (262) 786-0912
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2698123 | Other | WI | STATE OF WIS DEPT OF REGU |
| 39534600 | 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 |
|---|---|---|---|
| 2698123LCSW | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1588713705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19090 STILL POINT TRAIL",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "53045",
"telephone_number": "262-786-0912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12065 W JANESVILLE ROAD",
"city": "HALES CORNERS",
"state": "WI",
"postal_code": "53130",
"telephone_number": "414-425-2655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOLF",
"first_name": "DENNIS",
"middle_name": "KEITH",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "2698123LCSW",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF WIS DEPT OF REGU",
"identifier": "2698123",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39534600",
"state": "WI"
}
],
"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 Jul 8, 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.