Active NPI
Cynthia Leigh Tiesling, MSW, LCSW
- Social Worker
- Green Bay, WI
National Provider Identifier
1639353048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 378-123
- Practice address
- 2339 Cedar RDG
Suite 4
Green Bay, WI 54313-5700 - Phone
- (920) 497-6161
- Fax
- (920) 498-0476
- NPI assigned
- Dec 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 378-123 | WI | Primary |
Addresses
Primary practice location
2339 Cedar RDG
Suite 4
Green Bay, WI 54313-5700
Mailing address
2339 Cedar RDG
Suite 4
Green Bay, WI 54313-5700
Phone (920) 497-6161
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39284900 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 378-123 | WI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198108800000",
"number": "1639353048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2339 CEDAR RDG",
"address_2": "SUITE 4",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543135700",
"telephone_number": "920-497-6161",
"fax_number": "920-498-0476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2339 CEDAR RDG",
"address_2": "SUITE 4",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543135700",
"telephone_number": "920-497-6161",
"fax_number": "920-498-0476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIESLING",
"first_name": "CYNTHIA",
"middle_name": "LEIGH",
"credential": "MSW, LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-20",
"last_updated": "2007-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WI",
"license": "378-123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39284900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.