Lori E King, LCSW
Individual provider Active NPI Clinical Social Worker · Prairie Du Sac, WI
NPI 1902431380 · NPPES record last updated Dec 3, 2020
Key facts
- NPI
- 1902431380
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 9308-123 (WI)
- Practice address
- 1190 Prairie St
Prairie Du Sac, WI 53578-2044 - Phone
- (608) 370-6551
- Fax
- (608) 370-6554
- NPI assigned
- Mar 6, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Psychology Clinic Inc.
Practice addresses (Care Compare)
1190 Prairie St
Prairie Du Sac, WI 53578-2044
Phone (608) 370-6551
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210420001443 | WI | Practitioner - Clinical Social Worker | 0345658910 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9308-123 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychology Clinic Inc. | Current |
Accepting new patients | |
| Christianson Pfau Chiropractic LLC | Past |
Accepting new patients |
Locations
137 3rd Ave
Baraboo, WI 53913
Phone (608) 448-2797
702 N Blackhawk Ave
Ste 212
Madison, WI 53705
Phone (608) 238-9991
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 9308-123 | WI | Yes |
Addresses
Primary practice location
1190 Prairie St
Prairie Du Sac, WI 53578-2044
Mailing address
233 Spruce St
Sauk City, WI 53583-1039
Phone (715) 790-3951
Other practice location 1
137 3rd Ave
Baraboo, WI 53913-2421
Phone (608) 448-2797
Other providers in Prairie Du Sac, WI
- Kenneth Gordon Kalinowski
- Christina L Karg
- Julie A Kastelitz
- Bryant Randall Kearney
- Holly J Kindschi
- Breana Kirch
- Bruce M Koch
- Kristin Kolodziej
- Carly Marie Kraemer
- Alicia C Krizan
All providers in Prairie Du Sac, WI · Clinical Social Worker in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.