Linell K Berkley
Individual provider Active NPI Social Worker · Menasha, WI
NPI 1649420134 · NPPES record last updated Sep 24, 2008
Key facts
- NPI
- 1649420134
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 7363 (WI)
- Practice address
- 1095 Midway Rd
Menasha, WI 54952-1115 - Phone
- (920) 720-2300
- NPI assigned
- Sep 22, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Farrar and Associates Mental Health SC
Practice addresses (Care Compare)
16 Tri Park Way
Appleton, WI 54914-1658
Phone (920) 841-8326
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 |
|---|---|---|---|---|
| I20081209000209 | WI | Practitioner - Clinical Social Worker | 3476614405 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7363 | WI | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Farrar and Associates Mental Health SC | Current |
Accepting new patients |
Locations
16 Tri Park Way
Appleton, WI 54914
Phone (920) 841-8326
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 7363 | WI | Yes |
Addresses
Primary practice location
1095 Midway Rd
Menasha, WI 54952-1115
Mailing address
1095 Midway Rd
Menasha, WI 54952-1115
Phone (920) 720-3806
Other providers in Menasha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2008. 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.