Individual provider Active NPI

Cynthia R. Thomas, MSW

  • Social Worker
  • Green Bay, WI
National Provider Identifier
1780868125
Registry record updated Apr 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
2339 Cedar RDG
Suite 4
Green Bay, WI 54313-5700
Phone
(920) 497-6161
Fax
(920) 498-0476
NPI assigned
Dec 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2011

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 Primary

Addresses

Primary practice location

2339 Cedar RDG
Suite 4
Green Bay, WI 54313-5700

Mailing address

1499 Sixth St.
Suite 4
Green Bay, WI 54304
Phone (920) 497-6161

Other identifiers 1

IdentifierTypeStateIssuer
39284800MedicaidWI

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
I20140723002716 WI Practitioner - Clinical Social Worker 3476699190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Innovative Counseling IncGroup PAC ID 8022154749, 15 clinicians

Practice addresses (Care Compare)

1499 6TH St
Green Bay, WI 54304-2252
Phone (920) 497-6161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Counseling Inc CurrentSince Jul 7, 2014 Accepting new patients

Locations

1499 6th St
Green Bay, WI 54304
Phone (920) 497-6161

1499 6th St
Ste 4
Green Bay, WI 54304

2339 Cedar Rdg
Ste 4
Green Bay, WI 54313
Phone (920) 497-6161

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302566400000",
    "number": "1780868125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1499 SIXTH ST.",
            "address_2": "SUITE 4",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54304",
            "telephone_number": "920-497-6161",
            "fax_number": "920-498-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2339 CEDAR RDG",
            "address_2": "SUITE 4",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543135700",
            "telephone_number": "920-497-6161",
            "fax_number": "920-498-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "CYNTHIA",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-20",
        "last_updated": "2011-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39284800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.