Individual provider Active NPI

Lissa R Myhre, MS

  • Clinical Social Worker
  • Janesville, WI
National Provider Identifier
1891966297
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4254-123 Issued in WI
Practice address
1 S Main St
Janesville, WI 53545-3977
Phone
(608) 757-0404
Fax
(608) 757-2319
NPI assigned
Mar 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 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 4254-123 WI Primary

Addresses

Primary practice location

1 S Main St
Janesville, WI 53545-3977

Mailing address

1 S Main St
PO Box 8010
Janesville, WI 53545-3977
Phone (608) 757-0404

Other identifiers 1

IdentifierTypeStateIssuer
39642700MedicaidWI

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
I20181022002800 WI Practitioner - Clinical Social Worker 6507119567 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
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)

8215 Greenway Blvd
Suite 160
Middleton, WI 53562-3689
Phone (608) 236-4460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4254-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Counseling Services LTD. CurrentSince Sep 1, 2018 Accepting new patients
Cornerstone Counseling Services, Inc CurrentSince Apr 7, 2025 Accepting new patients

Locations

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

1 S Main St
Ste 250
Janesville, WI 53545
Phone (608) 757-0404

1 S Main St
Janesville, WI 53545
Phone (608) 757-0404

2901 W Beltline Hwy
Ste 301
Madison, WI 53713
Phone (608) 235-4460

8215 Greenway Blvd
Ste 160
Middleton, WI 53562
Phone (608) 801-4741

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1891966297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S MAIN ST",
            "address_2": "PO BOX 8010",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535453977",
            "telephone_number": "608-757-0404",
            "fax_number": "608-757-2319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S MAIN ST",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535453977",
            "telephone_number": "608-757-0404",
            "fax_number": "608-757-2319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYHRE",
        "first_name": "LISSA",
        "middle_name": "R",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "4254-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39642700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.