Individual provider Active NPI

Byron Hinz, LCSW, SAC

  • Clinical Social Worker
  • Anitgo, WI
National Provider Identifier
1790879377
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4239-123 Issued in WI
Practice address
1225 Langlade Road
Anitgo, WI 54409
Phone
(715) 623-2394
Fax
(715) 627-4194
NPI assigned
Oct 3, 2006
Last updated
Apr 15, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4239-123 WI Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 11735-131 WI

Addresses

Primary practice location

1225 Langlade Road
Anitgo, WI 54409

Mailing address

1100 Lake View Dr
Wausau, WI 54403-6785
Phone (715) 848-4600

Other identifiers 2

IdentifierTypeStateIssuer
4239-123OtherWISTATE LICENSE
11735-131OtherWISTATE LICENSE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11735-131WIMDAddiction (Substance Use Disorder) Counselor
4239-123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1790879377",
    "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": "544036785",
            "telephone_number": "715-848-4600",
            "fax_number": "715-845-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 LANGLADE ROAD",
            "city": "ANITGO",
            "state": "WI",
            "postal_code": "54409",
            "telephone_number": "715-623-2394",
            "fax_number": "715-627-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINZ",
        "first_name": "BYRON",
        "credential": "LCSW, SAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "4239-123",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "11735-131",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4239-123",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "11735-131",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anitgo, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; 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.