Kimberly Crowell, MSW

Individual provider Active NPI Clinical Social Worker · Portage, WI

NPI 1992301683 · NPPES record last updated Dec 8, 2020

Key facts

NPI
1992301683
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
9551-123 (WI)
Practice address
2901 Hunters TRL
Portage, WI 53901-3403
Phone
(608) 742-5518
Fax
(608) 742-4087
NPI assigned
Dec 8, 2020
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Service Associates, SC (34 clinicians)

Practice addresses (Care Compare)

50 Prairie Ave
Prairie Du Sac, WI 53578-1541
Phone (608) 643-3147

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 IDStateProvider typePAC IDDetails
I20201229000045 WI Practitioner - Clinical Social Worker 7113330754 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Community Service Associates, SC Current
since Dec 10, 2020
Accepting new patients

Locations

1002 Lincoln Ave
Baraboo, WI 53913
Phone (608) 356-9055

2901 Hunters Trl
Portage, WI 53901
Phone (608) 742-5518

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9551-123 WI Yes

Addresses

Primary practice location

2901 Hunters TRL
Portage, WI 53901-3403

Mailing address

PO Box 301
Portage, WI 53901-0301
Phone (608) 742-5518

Other providers in Portage, WI

All providers in Portage, WI · Clinical Social Worker in Wisconsin

Sources for this page

Verify at the official NPI Registry.