Individual provider Active NPI

Anthony Tickler, MSW, APSW

  • Social Worker
  • Marinette, WI
National Provider Identifier
1912412669
Registry record updated Dec 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
130756-121 Issued in WI
Practice address
2500 Hall Ave
Marinette, WI 54143-1655
Phone
(715) 732-7760
Fax
(715) 732-7711
NPI assigned
Dec 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 130756-121 WI Primary

Addresses

Primary practice location

2500 Hall Ave
Marinette, WI 54143-1655

Mailing address

2500 Hall Ave
Marinette, WI 54143-1655
Phone (715) 732-7760

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
130756-121WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Marinette 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.

NPI Registry JSON

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1912412669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 HALL AVE",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431655",
            "telephone_number": "715-732-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HALL AVE",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431655",
            "telephone_number": "715-732-7760",
            "fax_number": "715-732-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICKLER",
        "first_name": "ANTHONY",
        "credential": "MSW, APSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "130756-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.