Individual provider Active NPI

Pratibha Srivastava

  • Clinical Social Worker
  • Brookfield, WI
National Provider Identifier
1851845978
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8460-123 Issued in WI
Practice address
15875 Brook LN
Brookfield, WI 53005-1460
Phone
(262) 527-1359
NPI assigned
Aug 5, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LICSW126924 MA
Clinical Social Worker 1041C0700X 15504 CT
Clinical Social Worker 1041C0700X 44SC06591300 NJ
Clinical Social Worker 1041C0700X 5735 NH
Clinical Social Worker 1041C0700X 0904020577 VA
Clinical Social Worker 1041C0700X 8460-123 WI Primary

Addresses

Primary practice location

15875 Brook LN
Brookfield, WI 53005-1460

Mailing address

15875 Brook LN
Brookfield, WI 53005-1460
Phone (262) 527-1359

Other names 1

  • Ms. Pratibha Srivastava Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MA, CT, NH, NJ5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20160826000324 WI Practitioner - Clinical Social Worker 3274828413 Reassigns benefits to 2 organizations
I20250701000956 MA Practitioner - Clinical Social Worker 3274828413 Reassigns benefits to 1 organization
I20251219003741 CT Practitioner - Clinical Social Worker 3274828413 Reassigns benefits to 1 organization
I20251219003816 NH Practitioner - Clinical Social Worker 3274828413 Reassigns benefits to 1 organization
I20251223002487 NJ Practitioner - Clinical Social Worker 3274828413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Medical PAGroup PAC ID 3678948809, 92 clinicians
Talkspace Provider Network PAGroup PAC ID 5799136701, 249 clinicians

Practice addresses (Care Compare)

Milwaukee, WI 53202
Phone (415) 360-3348

4026 S Burrell St
Milwaukee, WI 53207-4404
Phone (561) 221-5696

7 Sibley Rd
Winchendon, MA 01475-1056
Phone (508) 733-2732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8460WIMDMental Health Counselor
15504CTMDClinical Social Worker
LICSW126924MAMDClinical Social Worker
5735NHMDClinical Social Worker
44SC06591300NJMDClinical Social Worker
0904020577VAMDClinical Social Worker
8460-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Talkspace Provider Network PA CurrentSince Mar 30, 2024 Accepting new patients
Talkspace Behavioral Health Services NJ, PC CurrentSince Nov 28, 2025 Accepting new patients
Brightside Medical, P.a. CurrentSince Feb 1, 2024 Accepting new patients
Glassman & Stanik Consulting Psychologists, LLC Past Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

2578 Broadway
Ste 607
New York, NY 10025
Phone (304) 308-3735

777 N Jefferson St
Ste 408
Milwaukee, WI 53202
Phone (414) 367-8494

Organizations & group practices 4

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": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1851845978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15875 BROOK LN",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530051460",
            "telephone_number": "262-527-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15875 BROOK LN",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530051460",
            "telephone_number": "262-527-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRIVASTAVA",
        "first_name": "PRATIBHA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-05",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW126924",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "15504",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06591300",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "5735",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904020577",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8460-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PRATIBHA",
            "last_name": "SRIVASTAVA",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.