Individual provider Active NPI

Crystal Colleen Lochhead

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1770982332
Registry record updated Oct 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9022 Issued in WI
Practice address
959 N Mayfair Rd
Milwaukee, WI 53226-3465
Phone
(414) 955-7601
Fax
(414) 955-6020
NPI assigned
Aug 20, 2014
Last updated
Oct 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2018

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 9022 WI Primary

Addresses

Primary practice location

959 N Mayfair Rd
Milwaukee, WI 53226-3465

Mailing address

959 N Mayfair Rd
Milwaukee, WI 53226-3465
Phone (414) 955-7601

Other identifiers 1

IdentifierTypeStateIssuer
1770982332MedicaidWI

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
I20181025000941 WI Practitioner - Clinical Social Worker 9436402286 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

W129N7055 Northfield Dr
Menomonee Falls, WI 53051-0538
Phone (262) 253-5400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9022WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jan 1, 2021 Accepting new patients
Froedtert &the Medical College of Wisconsin Community Physicians, Inc. CurrentSince Jan 1, 2021 Accepting new patients
The Medical College of Wisconsin, Inc. CurrentSince Sep 14, 2018 Accepting new patients
Mosaic Counseling, LLC Past Accepting new patients

Locations

W168N11237 Western Ave
Germantown, WI 53022
Phone (262) 253-5060

N74W12501 Leatherwood Ct
Menomonee Falls, WI 53051
Phone (414) 454-4744

W129N7055 Northfield Dr
Menomonee Falls, WI 53051
Phone (262) 251-5305

W129N7055 Northfield Dr
Ste 100
Menomonee Falls, WI 53051
Phone (262) 253-2510

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

Organizations & group practices 4

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": "1408492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1770982332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 N MAYFAIR RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263465",
            "telephone_number": "414-955-7601",
            "fax_number": "414-955-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 N MAYFAIR RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263465",
            "telephone_number": "414-955-7601",
            "fax_number": "414-955-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCHHEAD",
        "first_name": "CRYSTAL",
        "middle_name": "COLLEEN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-20",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770982332",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.