Individual provider Active NPI

Phyllis Ann Pleuss, LCSW

  • Clinical Social Worker
  • Beaver Dam, WI
National Provider Identifier
1912100298
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6117123 Issued in WI
Practice address
1200 North Center Street
Lutheran Social Services
Beaver Dam, WI 53916
Phone
(920) 887-3172
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6117123 WI Primary

Addresses

Primary practice location

1200 North Center Street
Lutheran Social Services
Beaver Dam, WI 53916

Mailing address

206 Blue Ridge Parkway
Madison, WI 53705-2418
Phone (608) 827-5698

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6117123WIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912100298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 BLUE RIDGE PARKWAY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537052418",
            "telephone_number": "608-827-5698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NORTH CENTER STREET",
            "address_2": "LUTHERAN SOCIAL SERVICES",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "53916",
            "telephone_number": "920-887-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLEUSS",
        "first_name": "PHYLLIS",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "6117123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Dam, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.