Trever Jaymes Allcock, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11488-123

Practice address

320 S. Walnut St.
Appleton, WI 54911-5918

Phone

(920) 832-5270

Fax

(920) 832-4767

NPI assigned

Oct 4, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• County of Outagamie

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Appleton, WI
  • NPI 1629138995

  WI

  Medicare reassignment NPD

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1679114136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 S. WALNUT ST.",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115918",
            "telephone_number": "920-832-5270",
            "fax_number": "920-832-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S. WALNUT ST.",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115918",
            "telephone_number": "920-832-5270",
            "fax_number": "920-832-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLCOCK",
        "first_name": "TREVER",
        "middle_name": "JAYMES",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-04",
        "last_updated": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11469-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "11488-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100094722",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "GJBHEALTHSERVICES.COM",
            "affiliation": "N",
            "address_1": "711 N Lynndale Dr",
            "city": "Appleton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549143078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Eric Allen, SAC-IT
• Mona Jean Allen, OTR/L
• Allergy and Asthma Associates, SC
• John N Allhiser, MD

• All providers in Appleton, WI
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.