Individual provider Active NPI

Jennifer Ann Marie Reisel

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1871112433
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7221-123 Issued in WI
Practice address
10850 W Park PL Ste 100
Milwaukee, WI 53224-3636
Phone
(262) 789-1191
NPI assigned
Apr 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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 7221-123 WI Primary

Addresses

Primary practice location

10850 W Park PL Ste 100
Milwaukee, WI 53224-3636

Mailing address

10850 W Park PL Ste 100
Milwaukee, WI 53224-3636
Phone (262) 789-1191

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
I20200722003087 WI Practitioner - Clinical Social Worker 1951725084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cornerstone Counseling Services IncGroup PAC ID 1456256023, 338 clinicians

Practice addresses (Care Compare)

10850 W Park Place
Suite 100
Milwaukee, WI 53224-3636
Phone (262) 789-1191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7221-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Counseling Services, Inc CurrentSince Jun 4, 2020 Accepting new patients

Locations

16535 W Bluemound Rd
Ste 200
Brookfield, WI 53005
Phone (262) 789-0909

10850 W Park Pl
Ste 100
Milwaukee, WI 53224
Phone (414) 361-4100

5650 N Green Bay Ave
Ste 205
Milwaukee, WI 53209
Phone (833) 314-1716

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.jenniferreisel@149809.advancedmd-direct.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1871112433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 W PARK PL STE 100",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532243636",
            "telephone_number": "262-789-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10850 W PARK PL STE 100",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532243636",
            "telephone_number": "262-789-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISEL",
        "first_name": "JENNIFER",
        "middle_name": "ANN MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-14",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7221-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.