Individual provider Active NPI

Melissa Caitlin Waldo, LCSW

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1851637102
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7950-123 Issued in WI
Practice address
1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203
Phone
(414) 672-1353
NPI assigned
Dec 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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 7950-123 WI Primary

Addresses

Primary practice location

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204-2203

Mailing address

PO Box 778789
Chicago, IL 60677-8789
Phone (414) 672-1353

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130715000470 WI Practitioner - Clinical Social Worker 3678713682 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sixteenth Street Community Health Centers, Inc. CurrentSince Sep 14, 2017 Accepting new patients
Sixteenth Street Community Health Centers, Inc. CurrentSince Sep 14, 2017 Accepting new patients
16TH Street Community Health Center Inc. Current Accepting new patients

Locations

2906 S 20th St
Milwaukee, WI 53215
Phone (414) 385-8800

1635 W National Ave
Milwaukee, WI 53204
Phone (262) 408-5094

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204

4570 S 27th St
Milwaukee, WI 53221
Phone (414) 325-8720

309 E North St
Waukesha, WI 53188
Phone (262) 408-2530

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1851637102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778789",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606778789",
            "telephone_number": "414-672-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 S CESAR E CHAVEZ DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042203",
            "telephone_number": "414-672-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDO",
        "first_name": "MELISSA",
        "middle_name": "CAITLIN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-13",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7950-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.