Stephanie A Daugherty-Dennis, MSW, CISW
Individual provider Active NPI Clinical Social Worker · Monona, WI
NPI 1619251733 · NPPES record last updated Dec 4, 2023
Key facts
- NPI
- 1619251733
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Practice address
- 2000 Engel St Ste 201
Monona, WI 53713-4822 - Phone
- (608) 440-9029
- Fax
- (608) 455-0883
- NPI assigned
- Oct 7, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Forward Counseling and Consultation LLC
Practice addresses (Care Compare)
2000 Fordem Ave
Madison, WI 53704-4600
Phone (608) 455-6070
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250611003075 | WI | Practitioner - Clinical Social Worker | 9133639768 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Starlight Counseling LLC | Current |
Accepting new patients | |
| Forward Counseling and Consultation LLC | Mental Health | Current |
Accepting new patients |
Locations
2000 Fordem Ave
Madison, WI 53704
Phone (608) 280-2740
1001 W Glen Oaks Ln
Ste 105
Mequon, WI 53092
Phone (414) 258-8314
2000 Engel St
Ste 201
Monona, WI 53713
Phone (608) 255-5135
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | Yes |
Addresses
Primary practice location
2000 Engel St Ste 201
Monona, WI 53713-4822
Mailing address
1101 Starlight Dr
Madison, WI 53711-2727
Phone (608) 316-5687
Other providers in Monona, WI
- Anthony J Curcio
- Molly Patricia Dillon Czech
- Dane County Cytology Center, Inc
- Dane County Family Acupuncture
- Rosa Daneshvar
- Rachel Dawson
- Day One Mental Health Services
- Dennis R Sherraden, DDS, LLC
- Daniel E Di Cerbo
- Discover Family Chiropractic, LLC
All providers in Monona, WI · Clinical Social Worker in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.