Active NPI
Brittany Perez, LCSW
- Clinical Social Worker
- Kenosha, WI
National Provider Identifier
1699269282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 9779-123
- Practice address
- 2108 63Rd St
Kenosha, WI 53143-4454 - Phone
- (262) 652-2406
- NPI assigned
- Jun 18, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 10845 | KS | |
| Clinical Social Worker | 1041C0700X | 9779-123 | WI | Primary |
Addresses
Primary practice location
2108 63Rd St
Kenosha, WI 53143-4454
Mailing address
PO Box 477
Garden City, KS 67846-0477
Phone (620) 275-0644
Other practice location 1
1111 E Spruce St
Garden City, KS 67846-5958
Phone (620) 276-7689
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10845 | KS | MD | Social Worker |
| 9779-123 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Compass Health Connection | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Garden City, KS
- NPI 1831569128
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634256000000",
"number": "1699269282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 477",
"city": "GARDEN CITY",
"state": "KS",
"postal_code": "678460477",
"telephone_number": "620-275-0644",
"fax_number": "620-272-0239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2108 63RD ST",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531434454",
"telephone_number": "262-652-2406"
}
],
"practiceLocations": [
{
"address_1": "1111 E Spruce St",
"address_purpose": "LOCATION",
"city": "Garden City",
"state": "KS",
"postal_code": "678465958",
"country_code": "US",
"telephone_number": "620-276-7689",
"fax_number": "620-276-6117",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEREZ",
"first_name": "BRITTANY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-18",
"last_updated": "2021-10-15",
"certification_date": "2021-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "KS",
"license": "10845",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "9779-123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.