Individual provider Active NPI

Pamela A Clough, LCS

  • Clinical Social Worker
  • Green Bay, WI
National Provider Identifier
1609851963
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1826-123 Issued in WI
Practice address
301 E Saint Joseph St
Green Bay, WI 54301-2241
Phone
(920) 433-6073
NPI assigned
Dec 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 1826-123 WI Primary

Addresses

Primary practice location

301 E Saint Joseph St
Green Bay, WI 54301-2241

Mailing address

PO Box 22040
Green Bay, WI 54305-2040
Phone (920) 445-7222

Other practice location 1

3263 Eaton Rd
Green Bay, WI 54311-6830
Phone (920) 433-6700

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
I20050516000458 WI Practitioner - Clinical Social Worker 9638110174 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

3263 Eaton Rd
Green Bay, WI 54311-6830
Phone (920) 433-6700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1826-123WIMDClinical Social Worker
1826WIMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Psychiatric Center Inc Current Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince May 20, 2025 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince May 20, 2025 Accepting new patients
Bellin Psychiatric Center Inc. Clinical CurrentSince May 9, 2005 Accepting new patients

Locations

301 Saint Joseph St
Green Bay, WI 54301
Phone (920) 430-3630

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

3263 Eaton Rd
Green Bay, WI 54311
Phone (920) 433-6000

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1609851963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22040",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052040",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E SAINT JOSEPH ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012241",
            "telephone_number": "920-433-6073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3263 Eaton Rd",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543116830",
            "country_code": "US",
            "telephone_number": "920-433-6700",
            "fax_number": "920-433-6738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLOUGH",
        "first_name": "PAMELA",
        "middle_name": "A",
        "credential": "LCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-09",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "1826-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.