Active NPI
Celestine Ford, MSW
- Clinical Social Worker
- Milwaukee, WI
National Provider Identifier
1912176173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 3259-123
- Practice address
- 1212 S 70TH St Ste 115a
Milwaukee, WI 53214-3105 - Phone
- (414) 902-1500
- Fax
- (414) 902-1515
- NPI assigned
- Feb 21, 2008
- 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 | 12717-131 | WI | |
| Clinical Social Worker | 1041C0700X | 3259-123 | WI | Primary |
Addresses
Primary practice location
1212 S 70TH St Ste 115a
Milwaukee, WI 53214-3105
Mailing address
1212 S 70TH St Ste 115a
Milwaukee, WI 53214-3105
Phone (414) 902-1500
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39591800 | Medicaid | WI | |
| 12717-131 | Other | WI | SAC |
| 3259-123 | Other | WI | LCSW |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12717-131 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 3259-123 | WI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Causa, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- West Allis, WI
- NPI 1861669830
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203552000000",
"number": "1912176173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1212 S 70TH ST STE 115A",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532143105",
"telephone_number": "414-902-1500",
"fax_number": "414-902-1515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1212 S 70TH ST STE 115A",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532143105",
"telephone_number": "414-902-1500",
"fax_number": "414-902-1515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORD",
"first_name": "CELESTINE",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-21",
"last_updated": "2008-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "12717-131",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "3259-123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39591800",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SAC",
"identifier": "12717-131",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "3259-123",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.