Individual provider Active NPI

Jennifer Elizabeth Poe, MSW,LCSW

  • Clinical Social Worker
  • Wauwatosa, WI
National Provider Identifier
1699882464
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
WI-2666 Issued in WI
Practice address
1220 Dewey Ave
Wauwatosa, WI 53213-2504
Phone
(414) 454-6773
Fax
(414) 454-6522
NPI assigned
Aug 25, 2006
Last updated
Mar 28, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X WI-2666 WI Primary
Marriage & Family Therapist 106H00000X

Addresses

Primary practice location

1220 Dewey Ave
Wauwatosa, WI 53213-2504

Mailing address

1220 Dewey Ave
Wauwatosa, WI 53213-2504
Phone (414) 454-6773

Other identifiers 1

IdentifierTypeStateIssuer
41004300MedicaidWI

Other names 1

  • Mrs. Jennifer Paszkiewicz Former name

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
I20070522000093 WI Practitioner - Clinical Social Worker 2769589050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of North Carolina at Chapel Hill School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3800 N Mayfair Rd
Wauwatosa, WI 53222-2213
Phone (414) 536-8333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
WI-2666WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Counseling and Family Services of Wisconsin Inc Marriage & Family Therapist CurrentSince Oct 15, 2021 Accepting new patients
Aurora Psychiatric Hospital, Inc. Past Accepting new patients

Locations

3800 N Mayfair Rd
Wauwatosa, WI 53222
Phone (414) 536-8333

3800 N Mayfair Rd
#1
Wauwatosa, WI 53222
Phone (262) 536-8333

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1699882464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 DEWEY AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132504",
            "telephone_number": "414-454-6773",
            "fax_number": "414-454-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 DEWEY AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132504",
            "telephone_number": "414-454-6773",
            "fax_number": "414-454-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POE",
        "first_name": "JENNIFER",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "MSW,LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "WI-2666",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41004300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "PASZKIEWICZ",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.