Individual provider Active NPI

Nicole Wooters, LCSW

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1699228080
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8512-123 Issued in WI
Practice address
3522 W Lisbon Ave
Milwaukee, WI 53208
Phone
(414) 935-8000
Fax
(414) 344-3396
NPI assigned
Aug 2, 2016
Last updated
May 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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 8512-123 WI Primary

Addresses

Primary practice location

3522 W Lisbon Ave
Milwaukee, WI 53208

Mailing address

PO Box 80257
Milwaukee, WI 53208-8004
Phone (414) 935-8000

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
I20170306001835 WI Practitioner - Clinical Social Worker 5991089294 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Wisconsin School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3522 W Lisbon Ave
Milwaukee, WI 53208-1953
Phone 41493580001437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Kneip, PH.D., P.C. CurrentSince Aug 30, 2022 Accepting new patients
Progressive Community Health Centers, Inc. Clinical CurrentSince Jan 23, 2017 Accepting new patients

Locations

2923 Marketplace Dr
Ste 204
Fitchburg, WI 53719
Phone (608) 549-5781

1452 N 7th St
Fl 2
Milwaukee, WI 53205
Phone (414) 935-8000

3522 W Lisbon Ave
Milwaukee, WI 53208
Phone (414) 935-8000

945 N 12th St
Milwaukee, WI 53233
Phone (414) 219-5800

26422 Oakridge Dr
Ste 106
Wind Lake, WI 53185

Organizations & group practices 2

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": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527638400000",
    "number": "1699228080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80257",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532088004",
            "telephone_number": "414-935-8000",
            "fax_number": "414-344-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3522 W LISBON AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53208",
            "telephone_number": "414-935-8000",
            "fax_number": "414-344-3396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOTERS",
        "first_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2018-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8512-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.