Active NPI
Timothy John Schwaller, MSSW
- Clinical Social Worker
- West Allis, WI
National Provider Identifier
1851542864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4131-123
- Practice address
- 1126 S 70TH St
West Allis, WI 53214-3151 - Phone
- (415) 727-7289
- NPI assigned
- Oct 8, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4131-123 | WI | Primary |
| School Social Worker | 1041S0200X | 050912 | WI |
Addresses
Primary practice location
1126 S 70TH St
West Allis, WI 53214-3151
Mailing address
568 N 105TH St
Wauwatosa, WI 53226-4330
Phone (414) 774-7135
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1205 S 70TH St
Suite 301
West Allis, WI 53214-3167
Phone (414) 475-2788
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 050912 | WI | MD | School Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Services Group, Inc. | Current | Accepting new patients |
Locations
2108 63rd St
Kenosha, WI 53143
6233 39th Ave
Kenosha, WI 53142
Phone (262) 654-1004
1205 S 70th St
Ste 301
West Allis, WI 53214
Phone (414) 475-2788
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Kenosha, WI
- NPI 1619024262
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223424000000",
"number": "1851542864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "568 N 105TH ST",
"city": "WAUWATOSA",
"state": "WI",
"postal_code": "532264330",
"telephone_number": "414-774-7135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1126 S 70TH ST",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532143151",
"telephone_number": "415-727-7289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHWALLER",
"first_name": "TIMOTHY",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"credential": "MSSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-10-08",
"last_updated": "2008-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "4131-123",
"primary": true
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "WI",
"license": "050912",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Allis, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.