Individual provider Active NPI

Judith Ann Gilbert, ACSW, LCSW

  • Mental Health Counselor
  • Kenosha, WI
National Provider Identifier
1740226042
Registry record updated Mar 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
781 -123 Issued in WI
Practice address
4633 Washington Rd
Kenosha, WI 53144-4220
Phone
(262) 652-7222
Fax
(262) 652-1734
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 781 -123 WI Primary
Social Worker 104100000X

Addresses

Primary practice location

4633 Washington Rd
Kenosha, WI 53144-4220

Mailing address

4633 Washington Rd
Kenosha, WI 53144-4220
Phone (262) 652-7222

Other identifiers 3

IdentifierTypeStateIssuer
935558OtherWIPHCS
306112775OtherWIUNITED BEHAVIORAL HEALTH
1740226042MedicaidWI

Other names 1

  • Miss Judith Ann Perkins Former name

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
781 -123WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Consulting of Kenosha LLC Social Worker PastSince Feb 4, 2012 Accepting new patients

Organizations & group practices 1

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1740226042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4633 WASHINGTON RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531444220",
            "telephone_number": "262-652-7222",
            "fax_number": "262-652-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4633 WASHINGTON RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531444220",
            "telephone_number": "262-652-7222",
            "fax_number": "262-652-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "JUDITH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "ACSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "781 -123",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "935558",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "306112775",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740226042",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "PERKINS",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "MSSW, ACSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.