Individual provider Active NPI

Sheryl Ann Dean, LCSW,BSW,CSAC,RCS

  • Clinical Social Worker
  • Mount Pleasant, WI
National Provider Identifier
1740309699
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9650-123 Issued in WI
Practice address
4810 Northwestern Ave
Mount Pleasant, WI 53406-1504
Phone
(262) 634-9984
Fax
(262) 637-9995
NPI assigned
Mar 29, 2007
Last updated
Apr 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 14349-131 WI
Clinical Social Worker 1041C0700X 9650-123 WI Primary

Addresses

Primary practice location

4810 Northwestern Ave
Mount Pleasant, WI 53406-1504

Mailing address

6200 W Center St
Milwaukee, WI 53210-2159
Phone (414) 874-2560

Other practice location 1

6200 W Center St
Milwaukee, WI 53210-2159
Phone (414) 874-2560 ext. 121

Other practice location 2

425 W Willow Ct Apt 234
Milwaukee, WI 53217-2657
Phone (414) 699-0294

Other identifiers 1

IdentifierTypeStateIssuer
39175200MedicaidWI

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
I20210708003383 WI Practitioner - Clinical Social Worker 0941602247 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14349-131WIMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lutheran Counseling and Family Services of Wisconsin Inc CurrentSince Jun 22, 2021 Accepting new patients

Locations

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

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, 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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1740309699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 W CENTER ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532102159",
            "telephone_number": "414-874-2560",
            "fax_number": "414-874-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 NORTHWESTERN AVE",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534061504",
            "telephone_number": "262-634-9984",
            "fax_number": "262-637-9995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6200 W Center St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532102159",
            "country_code": "US",
            "telephone_number": "414-874-2560 x121",
            "fax_number": "414-874-2565",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 W Willow Ct Apt 234",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532172657",
            "country_code": "US",
            "telephone_number": "414-699-0294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEAN",
        "first_name": "SHERYL",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW,BSW,CSAC,RCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "14349-131",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9650-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39175200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

Verify at the official NPI Registry.