Individual provider Active NPI

Pamela Hauke

  • Clinical Social Worker
  • Mount Pleasant, WI
National Provider Identifier
1750409009
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7187-123 Issued in WI
Practice address
6232 Bankers Rd Lowr Level
Mount Pleasant, WI 53403-9747
Phone
(262) 583-0137
Fax
(262) 583-0097
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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 12150 WI
Clinical Social Worker 1041C0700X 7187-123 WI Primary

Addresses

Primary practice location

6232 Bankers Rd Lowr Level
Mount Pleasant, WI 53403-9747

Mailing address

730 Sheridan Rd Apt 203
Kenosha, WI 53140-1181
Phone (262) 914-0507

Other identifiers 1

IdentifierTypeStateIssuer
11013500MedicaidWI

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
12150WIMDAddiction (Substance Use Disorder) Counselor
7187-123WIMDClinical Social Worker
7187WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1750409009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 SHERIDAN RD APT 203",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531401181",
            "telephone_number": "262-914-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6232 BANKERS RD LOWR LEVEL",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534039747",
            "telephone_number": "262-583-0137",
            "fax_number": "262-583-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUKE",
        "first_name": "PAMELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "12150",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7187-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11013500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.