Individual provider Active NPI

Joelle Lynn Wayer, LCSW

  • Clinical Social Worker
  • Verona, WI
National Provider Identifier
1790393395
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11274-123 Issued in WI
Practice address
524 W Verona Ave Ste 105
Verona, WI 53593-1443
Phone
(608) 845-2081
Fax
(608) 845-2065
NPI assigned
Jul 20, 2020
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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 11274-123 WI Primary

Addresses

Primary practice location

524 W Verona Ave Ste 105
Verona, WI 53593-1443

Mailing address

524 W Verona Ave Ste 105
Verona, WI 53593-1443
Phone (608) 845-2081

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
I20250708000671 WI Practitioner - Clinical Social Worker 0042724502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Safe Harbor Health LLCGroup PAC ID 1052729159, 6 clinicians

Practice addresses (Care Compare)

524 W Verona Ave
Suite 105
Verona, WI 53593-1443
Phone 60884520811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11274-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Harbor Health, LLC Clinical CurrentSince Mar 24, 2025 Accepting new patients
Open Door Center for Change LLC PastSince Aug 1, 2020 Accepting new patients

Locations

524 W Verona Ave
Ste 105
Verona, WI 53593
Phone (608) 845-2081

Organizations & group practices 2

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": "1595203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1790393395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 W VERONA AVE STE 105",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535931443",
            "telephone_number": "608-845-2081",
            "fax_number": "608-845-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 W VERONA AVE STE 105",
            "city": "VERONA",
            "state": "WI",
            "postal_code": "535931443",
            "telephone_number": "608-845-2081",
            "fax_number": "608-845-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAYER",
        "first_name": "JOELLE",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-20",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11274-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, WI

Sources for this page

Verify at the official NPI Registry.