Individual provider Active NPI

Solare Elizabeth O'Brien-Brethorst, APSW

  • Social Worker
  • Baraboo, WI
National Provider Identifier
1669072625
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
130908-121 Issued in WI
Practice address
505 Broadway St
Baraboo, WI 53913-2183
Phone
(608) 355-4200
NPI assigned
Oct 29, 2020
Last updated
Oct 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 130908-121 WI Primary

Addresses

Primary practice location

505 Broadway St
Baraboo, WI 53913-2183

Mailing address

505 Broadway St
Baraboo, WI 53913-2183
Phone (608) 355-4200

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
I20250116002218 WI Practitioner - Mental Health Counselor 5698203727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sauk CountyGroup PAC ID 7618931148, 13 clinicians

Practice addresses (Care Compare)

505 Broadway St
Baraboo, WI 53913-2183
Phone (608) 355-4200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
130908-121WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Sauk CurrentSince Dec 19, 2024 Accepting new patients
Sauk County Current Accepting new patients
Sauk County CurrentSince Dec 19, 2024 Accepting new patients
Sauk County Department of Human Services PastSince Nov 17, 2019 Accepting new patients

Locations

505 Broadway St
Baraboo, WI 53913
Phone (608) 355-4200

Organizations & group practices 4

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": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1669072625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 BROADWAY ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539132183",
            "telephone_number": "608-355-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 BROADWAY ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539132183",
            "telephone_number": "608-355-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN-BRETHORST",
        "first_name": "SOLARE",
        "middle_name": "ELIZABETH",
        "credential": "APSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "130908-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baraboo, WI

Sources for this page

Verify at the official NPI Registry.