Individual provider Active NPI

Marilyn C Holschuh, LCSW

  • Clinical Social Worker
  • Madison, WI
National Provider Identifier
1790737435
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
523-123 Issued in WI
Practice address
437 S Yellowstone Dr Ste 106
Madison, WI 53719-1096
Phone
(608) 268-0341
Fax
(608) 268-0342
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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 523-123 WI Primary

Addresses

Primary practice location

437 S Yellowstone Dr Ste 106
Madison, WI 53719-1096

Mailing address

6510 Grand Teton PLZ
Suite 406
Madison, WI 53719-1029
Phone (608) 833-9290

Other identifiers 3

IdentifierTypeStateIssuer
10536OtherWIDEAN HEALTH PLAN
42252500MedicaidWI
39517700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1790737435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6510 GRAND TETON PLZ",
            "address_2": "SUITE 406",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191029",
            "telephone_number": "608-833-9290",
            "fax_number": "608-833-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 S YELLOWSTONE DR STE 106",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191096",
            "telephone_number": "608-268-0341",
            "fax_number": "608-268-0342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLSCHUH",
        "first_name": "MARILYN",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "523-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN HEALTH PLAN",
            "identifier": "10536",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42252500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39517700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.