Individual provider Active NPI

John R Streyle, LCSW

  • Clinical Social Worker
  • La Crosse, WI
National Provider Identifier
1881690386
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2363 Issued in WI
Practice address
505 King St
Suite 025
La Crosse, WI 54601-9204
Phone
(608) 785-7000
Fax
(608) 785-7477
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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 2363 WI Primary

Addresses

Primary practice location

505 King St
Suite 025
La Crosse, WI 54601-9204

Mailing address

320 17TH St S
La Crosse, WI 54601-4925
Phone (608) 775-2287

Other identifiers 5

IdentifierTypeStateIssuer
130525OtherMNUCARE
39631200MedicaidWI
389K4STOtherMNBCBS-MN
HP46705OtherMNHEALTHPARTNERS
296318300MedicaidMN

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
I20110526000584 WI Practitioner - Clinical Social Worker 9335326446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2920 E Ave S
Suite 101
La Crosse, WI 54601-8282
Phone (608) 301-5181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2363WIMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Red Feather Therapy and Consulting, LLC CurrentSince Mar 14, 2011 Accepting new patients
Riverview Therapy, LLC Clinical Past Accepting new patients

Locations

2920 East Ave S
Ste 101
La Crosse, WI 54601
Phone (608) 466-6411

Organizations & group practices 2

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1881690386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 17TH ST S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014925",
            "telephone_number": "608-775-2287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 KING ST",
            "address_2": "SUITE 025",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546019204",
            "telephone_number": "608-785-7000",
            "fax_number": "608-785-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREYLE",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "130525",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39631200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-MN",
            "identifier": "389K4ST",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP46705",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296318300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.