Individual provider Active NPI

Lindsay M Krueger, LCSW, SAC-IT

  • Clinical Social Worker
  • Wausau, WI
National Provider Identifier
1790341279
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9701 Issued in WI
Practice address
1100 Lake View Dr
Wausau, WI 54403-6799
Phone
(715) 848-4600
NPI assigned
May 10, 2019
Last updated
May 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 18767 WI
Social Worker 104100000X 131489 WI
Clinical Social Worker 1041C0700X 9701 WI Primary

Addresses

Primary practice location

1100 Lake View Dr
Wausau, WI 54403-6799

Mailing address

1100 Lake View Dr
Wausau, WI 54403-6799
Phone (715) 848-4600

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
I20210623001572 WI Practitioner - Clinical Social Worker 6901207331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2400 Marshall St
Suite a
Wausau, WI 54403-6738
Phone (715) 848-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18767WIMDAddiction (Substance Use Disorder) Counselor
131489WIMDSocial Worker
9701WIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Human Services Board Serving North Central Health Care Facility Current Accepting new patients
Human Services Board Serving North Central Heatlh Care Facility CurrentSince Jun 1, 2021 Accepting new patients
Human Services Board Serving North Central Health Care Facility CurrentSince Jun 1, 2021 Accepting new patients

Locations

1225 Langlade Rd
Antigo, WI 54409
Phone (715) 623-2394

607 N Sales St
Ste 309
Merrill, WI 54452
Phone (715) 536-9482

1100 Lake View Dr
Wausau, WI 54403
Phone (715) 848-4454

2400 Marshall St
Ste A
Wausau, WI 54403
Phone (715) 848-4600

Organizations & group practices 3

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": "1557446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1790341279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 LAKE VIEW DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036799",
            "telephone_number": "715-848-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAKE VIEW DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036799",
            "telephone_number": "715-848-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "LINDSAY",
        "middle_name": "M",
        "credential": "LCSW, SAC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-10",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "18767",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "131489",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.