Active NPI
Joseph John Clymer, LCSW
- Clinical Social Worker
- Osceola, WI
National Provider Identifier
1780177840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8584123
- Practice address
- 405 Delmar Ave
Osceola, WI 54020 - Phone
- (651) 403-2145
- NPI assigned
- Jun 12, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 18119 | MN | |
| Clinical Social Worker | 1041C0700X | 8584123 | WI | Primary |
Addresses
Primary practice location
405 Delmar Ave
Osceola, WI 54020
Mailing address
100 Polk County PLZ Ste 50
Balsam Lake, WI 54810-9097
Phone (715) 485-8400
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18119 | MN | MD | Clinical Social Worker |
| 8584123 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528761600000",
"number": "1780177840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 POLK COUNTY PLZ STE 50",
"city": "BALSAM LAKE",
"state": "WI",
"postal_code": "548109097",
"telephone_number": "715-485-8400",
"fax_number": "715-485-8450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 DELMAR AVE",
"city": "OSCEOLA",
"state": "WI",
"postal_code": "54020",
"telephone_number": "651-403-2145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLYMER",
"first_name": "JOSEPH",
"middle_name": "JOHN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-12",
"last_updated": "2018-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "18119",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "8584123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Osceola, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.