NPIMap

Organization Active NPI

Aurora Community Counseling Employee Support and Services, Inc.

  • Social Worker
  • Siren, WI
National Provider Identifier
1639329113
Registry record updated Sep 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
2632 Issued in WI
Legal business name
AURORA COMMUNITY COUNSELING EMPLOYEE SUPPORT AND SERVICES, INC.
Practice address
24670 State Road 35 70
Suite 1200
Siren, WI 54872-4418
Phone
(715) 349-7233
Fax
(715) 349-7205
NPI assigned
Sep 22, 2008
Last updated
Sep 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2008

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

Authorized official

Name
Mrs. Kelly Johnson
Title
Credentialing Manager
Phone
(715) 532-9771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2632 WI Primary

Addresses

Primary practice location

24670 State Road 35 70
Suite 1200
Siren, WI 54872-4418

Mailing address

24670 State Road 35 70
Suite 1200
Siren, WI 54872-4418
Phone (715) 349-7233

Other identifiers 1

IdentifierTypeStateIssuer
42244500MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Aurora Community Counseling Employee Support and Services Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222041600000",
    "number": "1639329113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24670 STATE ROAD 35 70",
            "address_2": "SUITE 1200",
            "city": "SIREN",
            "state": "WI",
            "postal_code": "548724418",
            "telephone_number": "715-349-7233",
            "fax_number": "715-349-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24670 STATE ROAD 35 70",
            "address_2": "SUITE 1200",
            "city": "SIREN",
            "state": "WI",
            "postal_code": "548724418",
            "telephone_number": "715-349-7233",
            "fax_number": "715-349-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURORA COMMUNITY COUNSELING EMPLOYEE SUPPORT AND SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-22",
        "last_updated": "2008-09-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "715-532-9771",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "2632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42244500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Siren, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.