NPIMap

Organization Active NPI

County of Walworth

  • Community/Behavioral Health Agency
  • Elkhorn, WI
National Provider Identifier
1710189196
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COUNTY OF WALWORTH
Practice address
1910 County Road NN
Elkhorn, WI 53121-4454
Phone
(262) 741-3200
Fax
(262) 741-3217
NPI assigned
Jun 5, 2007
Organization subpart
Yes
Parent organization
COUNTY OF WALWORTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Authorized official

Name
Carlo Jon Nevicosi, MSW, LCSW
Title
Director
Phone
(262) 741-3200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1910 County Road NN
Elkhorn, WI 53121-4454

Mailing address

PO Box 1005
Elkhorn, WI 53121-1005
Phone (262) 741-3200

Other identifiers 1

IdentifierTypeStateIssuer
32980200MedicaidWI

Other names 1

  • Walworth County Department of Health and Human Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Walworth County Dept of14 organizations share this tax ID, including this one
Part of
Walworth County Dept of

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1710189196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1005",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531211005",
            "telephone_number": "262-741-3200",
            "fax_number": "262-741-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 COUNTY ROAD NN",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214454",
            "telephone_number": "262-741-3200",
            "fax_number": "262-741-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF WALWORTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF WALWORTH",
        "enumeration_date": "2007-06-05",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "NEVICOSI",
        "authorized_official_first_name": "CARLO",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "262-741-3200",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32980200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walworth County Department of Health and Human Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elkhorn, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.