Patricia Ann Modell, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

3008123LCSW Issued in WI

Practice address

5225 North Ironwood Rd.
Suite 102
Glendale, WI 53217

Phone

(414) 962-9156

Fax

(414) 962-4356

NPI assigned

Aug 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stress Management & Mental Health Clinics

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Allis, WI
  • NPI 1003928391
  NPD

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962510255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 NO IRONWOOD ROAD",
            "address_2": "STRESS MANAGEMENT",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-962-9156",
            "fax_number": "414-962-4356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 NORTH IRONWOOD RD.",
            "address_2": "SUITE 102",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-962-9156",
            "fax_number": "414-962-4356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODELL",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "3008123LCSW",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40963800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine C Mingo, MD
• Miracle Beginnings LLC
• Miracle Home Health of Wisconsin Inc
• Mobile Physician Clinics, LLC
• Alexandra Modell, L.AC.
• Stephen David Moerschel, APNP
• Aweis Jeilani Mohamed
• John Mooney, CPO1410
• Elizabeth Gayle Morgan, PHARMD
• Julie K Morgan, H.I.S.

• Social Worker in Glendale, WI
• Providers in Glendale, WI by specialty
• Social Worker in Wisconsin

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.