Individual provider Active NPI

Andrew M Silverman, LCSW

  • Clinical Social Worker
  • Shorewood, WI
National Provider Identifier
1699424127
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9608-123 Issued in WI
Practice address
2321 E Capitol Dr
Shorewood, WI 53211-2119
Phone
(414) 367-9111
NPI assigned
Mar 22, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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 9608-123 WI Primary

Addresses

Primary practice location

2321 E Capitol Dr
Shorewood, WI 53211-2119

Mailing address

2118A N Cambridge Ave
Milwaukee, WI 53202-1014
Phone (414) 367-9111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 19, 2024 through Dec 19, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9608-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Coast Therapy LLC Clinical CurrentSince Mar 27, 2022 Accepting new patients

Locations

2321 E Capitol Dr
Shorewood, WI 53211
Phone (414) 367-9111

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.

NPI Registry JSON

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1699424127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2118A N CAMBRIDGE AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532021014",
            "telephone_number": "414-367-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 E CAPITOL DR",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112119",
            "telephone_number": "414-367-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILVERMAN",
        "first_name": "ANDREW",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-22",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9608-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shorewood, WI

Sources for this page

Verify at the official NPI Registry.