Individual provider Active NPI

Lynn M Ollswang, ACSW LCSW

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1861464729
Registry record updated Nov 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1353123 Issued in WI
Practice address
2524 E. Webster Place
Suite 203
Milwaukee, WI 53211-4253
Phone
(414) 964-9200
Fax
(414) 964-4816
NPI assigned
Feb 6, 2006
Last updated
Nov 7, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2008

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 1353123 WI Primary

Addresses

Primary practice location

2524 E. Webster Place
Suite 203
Milwaukee, WI 53211-4253

Mailing address

2524 E. Webster PL.
Suite 203
Milwaukee, WI 53211-4253
Phone (414) 964-9200

Other identifiers 1

IdentifierTypeStateIssuer
39656400MedicaidWI

Other names 1

  • Miss Merelyn L Manegold Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1353123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226016000000",
    "number": "1861464729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2524 E. WEBSTER PL.",
            "address_2": "SUITE 203",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114253",
            "telephone_number": "414-964-9200",
            "fax_number": "414-964-4816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2524 E. WEBSTER PLACE",
            "address_2": "SUITE 203",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532114253",
            "telephone_number": "414-964-9200",
            "fax_number": "414-964-4816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLLSWANG",
        "first_name": "LYNN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "ACSW LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-06",
        "last_updated": "2008-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "1353123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39656400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MERELYN",
            "last_name": "MANEGOLD",
            "middle_name": "L",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.