Individual provider Active NPI

Henning Von Bauer, MSW, LCSW

  • Clinical Social Worker
  • Madison, WI
National Provider Identifier
1730107418
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6923-123 Issued in WI
Practice address
1320 Mendota St
Ste 106 Props
Madison, WI 53714-1096
Phone
(608) 280-3140
Fax
(608) 280-3143
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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 6923-123 WI Primary

Addresses

Primary practice location

1320 Mendota St
Ste 106 Props
Madison, WI 53714-1096

Mailing address

25 Kessel CT
Ste 105
Madison, WI 53711-6227
Phone (608) 280-2700

Other identifiers 1

IdentifierTypeStateIssuer
40942300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6923-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychology Clinic Inc. Past Accepting new patients
Catholic Charities Inc., Diocese of Madison Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1730107418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 KESSEL CT",
            "address_2": "STE 105",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537116227",
            "telephone_number": "608-280-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MENDOTA ST",
            "address_2": "STE 106 PROPS",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537141096",
            "telephone_number": "608-280-3140",
            "fax_number": "608-280-3143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON BAUER",
        "first_name": "HENNING",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "6923-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40942300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.