Active NPI
Jessica Jean McBride-Fought, MSW, LCSW, CSAC, ICS
- Clinical Social Worker
- Mequon, WI
National Provider Identifier
1881983427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7784-123
- Practice address
- 1317 W Towne Square Rd
Mequon, WI 53092-5017 - Phone
- (262) 241-5099
- NPI assigned
- Apr 5, 2011
- Last updated
- Jul 14, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 15420-132 | WI | |
| Clinical Social Worker | 1041C0700X | 7784-123 | WI | Primary |
Addresses
Primary practice location
1317 W Towne Square Rd
Mequon, WI 53092-5017
Mailing address
1317 W Towne Square Rd
Mequon, WI 53092-5017
Phone (262) 241-5099
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15420-132 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 7784-123 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342224000000",
"number": "1881983427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1317 W TOWNE SQUARE RD",
"city": "MEQUON",
"state": "WI",
"postal_code": "530925017",
"telephone_number": "262-241-5099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1317 W TOWNE SQUARE RD",
"city": "MEQUON",
"state": "WI",
"postal_code": "530925017",
"telephone_number": "262-241-5099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCBRIDE-FOUGHT",
"first_name": "JESSICA",
"middle_name": "JEAN",
"credential": "MSW, LCSW, CSAC, ICS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-05",
"last_updated": "2012-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "15420-132",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "7784-123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mequon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.