Shirley Wortham

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2817-226 Issued in WI

Practice address

N3152 State Road 81
Monroe, WI 53566-9397

Phone

(608) 328-9393

Fax

(608) 328-9480

NPI assigned

Mar 24, 2017

Last updated

Jul 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Shirley Ann Wortham Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• County of Green

  dba Green County Human Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Monroe, WI
  • NPI 1992925085
  NPD

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1710418314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N3152 STATE ROAD 81",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535669397",
            "telephone_number": "608-328-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N3152 STATE ROAD 81",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535669397",
            "telephone_number": "608-328-9393",
            "fax_number": "608-328-9480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2240 Prairie Ave",
            "address_purpose": "LOCATION",
            "city": "Beloit",
            "state": "WI",
            "postal_code": "535112648",
            "country_code": "US",
            "telephone_number": "608-361-7200 x226",
            "fax_number": "608-361-7202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WORTHAM",
        "first_name": "SHIRLEY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2024-07-26",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "281728",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "2817-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIRLEY",
            "last_name": "WORTHAM",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "CSAC, LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bartlett J Witherspoon Jr., MD
• Cassandra Wittmann
• Dylan Wittmann, ATC
• Donna Lynne Wolfe, NP
• Sheri Beth Wong, AGPCNP-BC
• Colette Wyttenbach, RD, CD, LD, CDE
• Michael Kai-Hua Yeh, MD
• Elisabeth A. Zgraggen, FNP
• Kayla Zimdars, CCC-SLP
• Angela A Zimmerman

• Professional Counselor in Monroe, WI
• Providers in Monroe, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; 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.