Individual provider Active NPI

Melissa Bartz, LCSW

  • Clinical Social Worker
  • Greenfield, WI
National Provider Identifier
1780314989
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12165-123 Issued in WI
Practice address
4811 S 76TH St Ste 208
Greenfield, WI 53220-4352
Phone
(833) 216-7555
NPI assigned
Jun 13, 2022
Last updated
Mar 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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 19587-130 WI
Clinical Social Worker 1041C0700X 12165-123 WI Primary

Addresses

Primary practice location

4811 S 76TH St Ste 208
Greenfield, WI 53220-4352

Mailing address

4811 S 76TH St Ste 208
Greenfield, WI 53220-4352
Phone (833) 216-7555

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
I20250321002744 WI Practitioner - Clinical Social Worker 6002338753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19587-130WIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1780314989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4811 S 76TH ST STE 208",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204352",
            "telephone_number": "833-216-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 S 76TH ST STE 208",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204352",
            "telephone_number": "833-216-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTZ",
        "first_name": "MELISSA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-13",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "19587-130",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "12165-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.