NPIMap

Organization Active NPI

Children's Service Society of Wisconsin

  • Clinical Social Worker
  • Kenosha, WI
National Provider Identifier
1821262684
Registry record updated Dec 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CHILDREN'S SERVICE SOCIETY OF WISCONSIN
Practice address
8207 22ND Ave
Suite 155
Kenosha, WI 53143-6211
Phone
(262) 652-5522
Fax
(262) 652-7228
NPI assigned
Apr 14, 2008
Last updated
Dec 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2013

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

Authorized official

Name
Ms. Tracy Oerter
Title
Interim Director of Counseling
Phone
(414) 266-2912

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

8207 22ND Ave
Suite 155
Kenosha, WI 53143-6211

Mailing address

8207 22ND Ave
Suite 155
Kenosha, WI 53143-6211
Phone (262) 652-5522

Other identifiers 1

IdentifierTypeStateIssuer
42210200MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Childrens Service Society15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

8207 22nd Ave
Ste 155
Kenosha, WI 53143
Phone (262) 652-5522

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386201600000",
    "number": "1821262684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8207 22ND AVE",
            "address_2": "SUITE 155",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531436211",
            "telephone_number": "262-652-5522",
            "fax_number": "262-652-7228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8207 22ND AVE",
            "address_2": "SUITE 155",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531436211",
            "telephone_number": "262-652-5522",
            "fax_number": "262-652-7228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S SERVICE SOCIETY OF WISCONSIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2013-12-05",
        "status": "A",
        "authorized_official_last_name": "OERTER",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "INTERIM DIRECTOR OF COUNSELING",
        "authorized_official_telephone_number": "414-266-2912",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42210200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.