Individual provider Active NPI

Nicole Helene Gies, LCSW, RADC-I

  • Clinical Social Worker
  • Menomonee Falls, WI
National Provider Identifier
1609912559
Registry record updated Oct 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7319-123 Issued in WI
Practice address
N91W17271 Appleton Ave
Menomonee Falls, WI 53051-2045
Phone
(262) 502-3300
Fax
(262) 532-9585
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 13989 WI
Clinical Social Worker 1041C0700X 7319-123 WI Primary

Addresses

Primary practice location

N91W17271 Appleton Ave
Menomonee Falls, WI 53051-2045

Mailing address

N91W17271 Appleton Ave
Menomonee Falls, WI 53051-2045
Phone (262) 502-3300

Other identifiers 1

IdentifierTypeStateIssuer
43717400MedicaidWI

Other names 1

  • Nicole Helene Lavin Former name

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
I20081003000498 WI Practitioner - Clinical Social Worker 2961570965 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13989WIMDAddiction (Substance Use Disorder) Counselor
7319-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Paws for Counseling Current Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Sep 4, 2010 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. Current Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

W129N7055 Northfield Dr
Menomonee Falls, WI 53051
Phone (262) 251-5305

N91W17271 Appleton Ave
Menomonee Fls, WI 53051
Phone (262) 502-3300

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

840 N 87th St
Wauwatosa, WI 53226
Phone (414) 805-5540

Organizations & group practices 3

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286236800000",
    "number": "1609912559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N91W17271 APPLETON AVE",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530512045",
            "telephone_number": "262-502-3300",
            "fax_number": "262-532-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N91W17271 APPLETON AVE",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530512045",
            "telephone_number": "262-502-3300",
            "fax_number": "262-532-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIES",
        "first_name": "NICOLE",
        "middle_name": "HELENE",
        "credential": "LCSW, RADC-I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2010-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "13989",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7319-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43717400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "LAVIN",
            "middle_name": "HELENE",
            "credential": "LCSW,RADC-I",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Menomonee Falls, WI

Sources for this page

Verify at the official NPI Registry.