Individual provider Active NPI

Stephanie A Daugherty-Dennis, MSW, CISW

  • Clinical Social Worker
  • Monona, WI
National Provider Identifier
1619251733
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 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
Last updated
Dec 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X Primary

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

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
I20250611003075 WI Practitioner - Clinical Social Worker 9133639768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forward Counseling and Consultation LLCGroup PAC ID 0042668709, 7 clinicians

Practice addresses (Care Compare)

2000 Fordem Ave
Madison, WI 53704-4600
Phone (608) 455-6070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Forward Counseling and Consultation LLC Mental Health CurrentSince May 1, 2025 Accepting new patients
Starlight Counseling LLC CurrentSince Dec 10, 2023 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

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1619251733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 STARLIGHT DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112727",
            "telephone_number": "608-316-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 ENGEL ST STE 201",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537134822",
            "telephone_number": "608-440-9029",
            "fax_number": "608-455-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY-DENNIS",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MSW, CISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-07",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monona, WI

Sources for this page

Verify at the official NPI Registry.