Individual provider Active NPI

Jill Colleen Nowlen, MSW, LCSW.

  • Clinical Social Worker
  • Summit, WI
National Provider Identifier
1669406690
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7243-123 Issued in WI
Practice address
36500 Aurora Dr
Summit, WI 53066-4899
Phone
(262) 434-5877
Fax
(262) 434-5809
NPI assigned
Jul 10, 2006
Last updated
Jul 11, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7243-123 WI Primary

Addresses

Primary practice location

36500 Aurora Dr
Summit, WI 53066-4899

Mailing address

36500 Aurora Dr
Summit, WI 53066-4899
Phone (262) 434-5877

Other identifiers 1

IdentifierTypeStateIssuer
43592300MedicaidWI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
7243-123WIMDClinical Social Worker
7243WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Counseling Center Past Accepting new patients
Integral Psychology Center PastSince Jan 21, 2009 Accepting new patients
Aspen Family Counseling PastSince Jan 14, 2013 Accepting new patients
Glassman & Stanik Consulting Psychologists, LLC Past Accepting new patients
Samaritan Counseling Center of Southern Wisconsin Inc PastSince Apr 22, 2009 Accepting new patients

Organizations & group practices 5

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1669406690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36500 AURORA DR",
            "city": "SUMMIT",
            "state": "WI",
            "postal_code": "530664899",
            "telephone_number": "262-434-5877",
            "fax_number": "262-434-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36500 AURORA DR",
            "city": "SUMMIT",
            "state": "WI",
            "postal_code": "530664899",
            "telephone_number": "262-434-5877",
            "fax_number": "262-434-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWLEN",
        "first_name": "JILL",
        "middle_name": "COLLEEN",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7243-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43592300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; 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.