NPIMap

Organization Active NPI

Harbor North Counseling

  • Clinical Social Worker
  • Washburn, WI
National Provider Identifier
1821294539
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW4352123 Issued in WI
Legal business name
HARBOR NORTH COUNSELING
Practice address
14 East Bayfield St
Washburn, WI 54891-0003
Phone
(715) 373-0480
Fax
(715) 373-0480
NPI assigned
Jun 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Mr. Timothy Phillip Faust, MSWNPI 1467658179
Title
Director Harbor North Counseling
Phone
(715) 373-0480

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X LCSW4352123 WI Primary

Addresses

Primary practice location

14 East Bayfield St
Washburn, WI 54891-0003

Mailing address

PO Box 3
14 East Bayfield St
Washburn, WI 54891-0003
Phone (715) 373-0480

Other identifiers 1

IdentifierTypeStateIssuer
4220850MedicaidWI

Other names 1

  • Harbor North Counseling Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1821294539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3",
            "address_2": "14 EAST BAYFIELD ST",
            "city": "WASHBURN",
            "state": "WI",
            "postal_code": "548910003",
            "telephone_number": "715-373-0480",
            "fax_number": "715-373-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 EAST BAYFIELD ST",
            "city": "WASHBURN",
            "state": "WI",
            "postal_code": "548910003",
            "telephone_number": "715-373-0480",
            "fax_number": "715-373-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR NORTH COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "FAUST",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "DIRECTOR HARBOR NORTH COUNSELING",
        "authorized_official_telephone_number": "715-373-0480",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "LCSW4352123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4220850",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harbor North Counseling",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Washburn, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.