Individual provider Active NPI

Brooke E Boss, APSW, RBT, MSW

  • Behavior Analyst
  • Delavan, WI
National Provider Identifier
1982218327
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
N4103 Dam Rd
Delavan, WI 53115-2979
Phone
(262) 441-1198
NPI assigned
Sep 2, 2020
Last updated
Oct 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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 132848-121 WI
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

N4103 Dam Rd
Delavan, WI 53115-2979

Mailing address

N4103 Dam Rd
Delavan, WI 53115-2979
Phone (262) 441-1198

Other practice location 1

N2846 State Road 67
Williams Bay, WI 53191-3771
Phone (262) 245-5608

Other practice location 2

903 Mineral Point Ave
Janesville, WI 53548-2970
Phone (608) 756-5555

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
I20251016004034 WI Practitioner - Clinical Social Worker 7012404536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

29624 Network PL
Chicago, IL 60673-1296

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
132848-121WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Oct 27, 2025 Accepting new patients
Mercy Health System Corporation CurrentSince Oct 27, 2025 Accepting new patients
Mercy Health System Corporation Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

903 Mineral Point Ave
Janesville, WI 53548
Phone (608) 756-5555

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

N2846 State Road 67
Williams Bay, WI 53191
Phone (262) 245-5608

Interoperability endpoints

  • Direct secure messaging: bboss78012@direct.mhemail.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1982218327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N4103 DAM RD",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531152979",
            "telephone_number": "262-441-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N4103 DAM RD",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531152979",
            "telephone_number": "262-441-1198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N2846 State Road 67",
            "address_purpose": "LOCATION",
            "city": "Williams Bay",
            "state": "WI",
            "postal_code": "531913771",
            "country_code": "US",
            "telephone_number": "262-245-5608",
            "fax_number": "262-245-5648",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "903 Mineral Point Ave",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535482970",
            "country_code": "US",
            "telephone_number": "608-756-5555",
            "fax_number": "608-756-0174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSS",
        "first_name": "BROOKE",
        "middle_name": "E",
        "credential": "APSW, RBT, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-02",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "132848-121",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delavan, WI

Sources for this page

Verify at the official NPI Registry.