Kimberly Lewis, LCSW, CSAC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

7377-123 Issued in WI

Practice address

140 W Main St Ste E
Winneconne, WI 54986-9409

Phone

(920) 460-9814

NPI assigned

Jun 20, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Growing Tree Counseling & Wellness

  • Clinical Social Worker
  • Winneconne, WI
  • NPI 1144531757
  NPD (past)

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1972942175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S. KENSINGTON DR. STE. 400",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549154186",
            "telephone_number": "920-659-0634",
            "fax_number": "920-239-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 W MAIN ST STE E",
            "city": "WINNECONNE",
            "state": "WI",
            "postal_code": "549869409",
            "telephone_number": "920-460-9814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KIMBERLY",
        "credential": "LCSW, CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "14548-132",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7377-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7377",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "7377-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FORWARD HEALTH",
            "identifier": "100194005",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972942175",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100194005",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "www.sole@soulcounseling.com",
            "affiliation": "N",
            "address_1": "2400 S Kensington Dr Ste 400",
            "city": "Appleton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549154187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joseph Walter Guerard, D.D.S.
• David J Hoenecke, RPH
• Alexandra Kellogg, D.C.
• Jennifer Krause
• Kathleen Helen Larson, MS, OTR
• Loyda O Loria, MD
• Christian D Marsh, DDS
• McGinnis Chiropractic Health Clinic
• McGinnis Chiropractic Office Inc
• Michael James McGinnis, DC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.