Stephanie Diane Mock, MSW
Individual provider Active NPI Social Worker · Madison, WI
NPI 1962124693 · NPPES record last updated Sep 19, 2022
Key facts
- NPI
- 1962124693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 128440 (WI)
- Practice address
- 700 Regent St
Madison, WI 53715-2634 - Phone
- (608) 441-3290
- NPI assigned
- Sep 19, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Family Therapy Center of Madison, Inc.
Group Health Cooperative of South Central Wisconsin
Practice addresses (Care Compare)
10 E Doty St
Suite 445
Madison, WI 53703-5107
Phone (608) 276-9191
8202 Excelsior Dr
Madison, WI 53717-1906
Phone (608) 831-1766
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 |
|---|---|---|---|---|
| I20250103000606 | WI | Practitioner - Clinical Social Worker | 6406383496 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 128440 | WI | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Group Health Cooperative of South Central Wisconsin | Current |
Accepting new patients | |
| Dane County Counseling Services SC | Current |
Accepting new patients |
Locations
8202 Excelsior Dr
Madison, WI 53717
Phone (608) 831-1766
1265 John Q Hammons Dr
Madison, WI 53717
700 Regent St
Madison, WI 53715
Phone (608) 441-3290
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 128440 | WI | Yes |
Addresses
Primary practice location
700 Regent St
Madison, WI 53715-2634
Mailing address
1265 John Q Hammons Dr
Madison, WI 53717-1921
Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2022. 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.