Individual provider Active NPI

Judy Lemke, LCSW, LPC

  • Clinical Social Worker
  • Wausau, WI
National Provider Identifier
1962559641
Registry record updated Dec 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3786-123 Issued in WI
Practice address
3600 Stewart Ave
Wausau, WI 54401-3944
Phone
(715) 842-9500
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3786-123 WI Primary
Professional Counselor 101YP2500X 1418-125 WI

Addresses

Primary practice location

3600 Stewart Ave
Wausau, WI 54401-3944

Mailing address

PO Box 442
Tomahawk, WI 54487-0442
Phone (715) 966-0962

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220105000410 WI Practitioner - Clinical Social Worker 7012308851

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1981
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

213 Stonefield Dr
Lake Mills, WI 53551-1965

PO Box
Suite 1508
Granby, CO 80446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1418-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Clinic, LLC Professional CurrentSince Nov 21, 2021 Accepting new patients

Locations

2417 Post Rd
Stevens Point, WI 54481
Phone (715) 544-6144

630 S 36th Ave
Wausau, WI 54401
Phone (414) 301-1060

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482796800000",
    "number": "1962559641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 442",
            "city": "TOMAHAWK",
            "state": "WI",
            "postal_code": "544870442",
            "telephone_number": "715-966-0962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 STEWART AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013944",
            "telephone_number": "715-842-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMKE",
        "first_name": "JUDY",
        "credential": "LCSW, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2016-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "3786-123",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "1418-125",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.