Individual provider Active NPI

Susan Kopp Townsley, LCSW

  • Clinical Social Worker
  • Viroqua, WI
National Provider Identifier
1780633529
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6737 - 123 Issued in WI
Practice address
414 S East Ave
Viroqua, WI 54665
Phone
(608) 638-3332
Fax
(608) 637-7328
NPI assigned
May 9, 2006
Last updated
Jun 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 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 6737 - 123 WI Primary

Addresses

Primary practice location

414 S East Ave
Viroqua, WI 54665

Mailing address

414 S East Ave
Viroqua, WI 54665-2006
Phone (608) 638-3332

Other identifiers 1

IdentifierTypeStateIssuer
40945800MedicaidWI

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
I20070330000331 WI Practitioner - Clinical Social Worker 7618071671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stonehouse Counseling LLCGroup PAC ID 0042569923, 2 clinicians

Practice addresses (Care Compare)

414 S E Ave
Viroqua, WI 54665-2006
Phone (608) 638-3332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6737 - 123WIMDClinical Social Worker

Organizations & group practices 1

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1780633529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 S EAST AVE",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546652006",
            "telephone_number": "608-638-3332",
            "fax_number": "608-637-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 S EAST AVE",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "54665",
            "telephone_number": "608-638-3332",
            "fax_number": "608-637-7328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOWNSLEY",
        "first_name": "SUSAN",
        "middle_name": "KOPP",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "6737 - 123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40945800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Viroqua, WI

Sources for this page

Verify at the official NPI Registry.