NPIMap

Organization Active NPI

Center for Human Development, Inc.

  • Mental Health Counselor
  • Wausau, WI
National Provider Identifier
1679684609
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1153 Issued in WI
Legal business name
CENTER FOR HUMAN DEVELOPMENT, INC.
Practice address
631 Forest St
Wausau, WI 54403-5524
Phone
(715) 842-0944
Fax
(715) 845-6477
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

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

Authorized official

Name
Mr. Edmund Lee Webster, MSW, LCSWNPI 1376576231
Title
Director
Phone
(715) 842-0944

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 1153 WI Primary

Addresses

Primary practice location

631 Forest St
Wausau, WI 54403-5524

Mailing address

631 Forest St
Wausau, WI 54403-5524
Phone (715) 842-0944

Other identifiers 5

IdentifierTypeStateIssuer
42135100MedicaidWI
62743OtherWIMULTIPLAN/WPPN
DA2153OtherRAILROAD MEDICARE
305912OtherMHN
1008111OtherCIGNA BEHAVIORAL HEALTH

Other names 1

  • Center for Human Development Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090814000206 WI Part B Supplier - Clinic/Group Practice 0345394037 Receives reassigned benefits from 9 practitioners
Practice locations: Wausau, WI

National Provider Directory

National Provider Directory

Locations

243 S Central Ave
Ste 109
Marshfield, WI 54449
Phone (715) 486-1555

2417 Post Rd
#H
Stevens Point, WI 54481
Phone (800) 236-3792

1141 N 4TH St Ste 101
Tomahawk, WI 54487

1411 N 4th St
Ste 101
Tomahawk, WI 54487

631 Forest St
Wausau, WI 54403
Phone (715) 842-0944

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409616000000",
    "number": "1679684609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 FOREST ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544035524",
            "telephone_number": "715-842-0944",
            "fax_number": "715-845-6477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 FOREST ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544035524",
            "telephone_number": "715-842-0944",
            "fax_number": "715-845-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR HUMAN DEVELOPMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-09-02",
        "status": "A",
        "authorized_official_last_name": "WEBSTER",
        "authorized_official_first_name": "EDMUND",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "715-842-0944",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "1153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42135100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN/WPPN",
            "identifier": "62743",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA2153",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "305912",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "1008111",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Human Development",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.