David Randall Block, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7848 Issued in WI

Practice address

100 County Road B
Shawano, WI 54166-7072

Phone

(800) 501-8247

Fax

(715) 524-1554

NPI assigned

Jul 12, 2006

Last updated

Jun 24, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1699790865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8003",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549128003",
            "telephone_number": "920-996-3200",
            "fax_number": "920-738-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COUNTY ROAD B",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541667072",
            "telephone_number": "800-501-8247",
            "fax_number": "715-524-1554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCK",
        "first_name": "DAVID",
        "middle_name": "RANDALL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801087203",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "DB087203",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aeric Berner, DC
• Katie Lynn Bero
• Kavit Lache Beyersdorf, OD
• Bio-Medical Applications of Wisconsin Inc (Fresenius Medical Care Shawano)
• Birch Hill Care Center LLC (Atrium Post Acute Care of Shawano at Birch Hill)
• Judith A Blum, O.T.R.
• Tiffani Lee Bohm, RN
• Robert Joseph Bohr Jr.
• Cynthia M Bohringer
• Shelby Borchers

• Clinical Social Worker in Shawano, WI
• Providers in Shawano, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.