Individual provider Active NPI

Alicia Wheeler, CAPSW

  • Social Worker
  • Green Bay, WI
National Provider Identifier
1750898458
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
129580-121 Issued in WI
Practice address
1039 W Mason St
Green Bay, WI 54303-1842
Phone
(920) 965-7707
NPI assigned
Jan 3, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 129580-121 WI Primary

Addresses

Primary practice location

1039 W Mason St
Green Bay, WI 54303-1842

Mailing address

1642 University Dr Apt 1
Menasha, WI 54952-1194

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
129580-121WIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1750898458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1642 UNIVERSITY DR APT 1",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 W MASON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543031842",
            "telephone_number": "920-965-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "ALICIA",
        "credential": "CAPSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "129580-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; 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.