Individual provider Active NPI

Laurie Dawn Linden, LCSW

  • Clinical Social Worker
  • Lake Geneva, WI
National Provider Identifier
1659618346
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7907-123 Issued in WI
Practice address
750 Veterans Pkwy Unit 100
Lake Geneva, WI 53147-4950
Phone
(262) 248-7942
Fax
(262) 249-7132
NPI assigned
Jan 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7907-123 WI Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15595-131 WI

Addresses

Primary practice location

750 Veterans Pkwy Unit 100
Lake Geneva, WI 53147-4950

Mailing address

750 Veterans Pkwy Unit 100
Lake Geneva, WI 53147-4950
Phone (262) 248-7942

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
I20130711000403 WI Practitioner - Clinical Social Worker 8325288590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Geneva Wellness Clinic LLCGroup PAC ID 7517139447, 7 clinicians

Practice addresses (Care Compare)

750 Veterans Pkwy
Unit 100
Lake Geneva, WI 53147-4950
Phone (262) 248-7942

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15595-131WIMDAddiction (Substance Use Disorder) Counselor
7907-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Geneva Wellness Clinic LLC CurrentSince Nov 1, 2020 Accepting new patients

Locations

750 Veterans Pkwy
Unit 100
Lake Geneva, WI 53147
Phone (262) 248-7942

1001 W Glen Oaks Ln
Ste 105
Mequon, WI 53092
Phone (414) 258-8314

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631836800000",
    "number": "1659618346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 VETERANS PKWY UNIT 100",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474950",
            "telephone_number": "262-248-7942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 VETERANS PKWY UNIT 100",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474950",
            "telephone_number": "262-248-7942",
            "fax_number": "262-249-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDEN",
        "first_name": "LAURIE",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-15",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7907-123",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15595-131",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Geneva, WI

Sources for this page

Verify at the official NPI Registry.