Individual provider Active NPI

Alexandra Dutton Wilk, LCSW

  • Clinical Social Worker
  • Mequon, WI
National Provider Identifier
1992410203
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11074123 Issued in WI
Practice address
11518 N Port Washington Rd Ste 202
Mequon, WI 53092-3443
Phone
(262) 490-0756
NPI assigned
Jan 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11074123 WI Primary

Addresses

Primary practice location

11518 N Port Washington Rd Ste 202
Mequon, WI 53092-3443

Mailing address

10422 W Hillside Ave
Wauwatosa, WI 53222-2323
Phone (262) 490-0756

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
I20250924000772 WI Practitioner - Clinical Social Worker 3274038021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Counseling Services IncGroup PAC ID 1456256023, 338 clinicians

Practice addresses (Care Compare)

11518 N Port Washington Rd
Suite 202
Mequon, WI 53092-3443
Phone (262) 244-6177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11074123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Counseling Services, Inc CurrentSince Jul 14, 2025 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

16535 W Bluemound Rd
Ste 200
Brookfield, WI 53005
Phone (262) 789-0909

11649 N Port Washington Rd
Ste 201
Mequon, WI 53092
Phone 2627891191380

11649 N Port Washington Rd
Ste 221
Mequon, WI 53092
Phone (262) 912-1922

11518 N Port Washington Rd
Ste 202
Mequon, WI 53092
Phone (262) 244-6177

1143 Warwick Way
Racine, WI 53406
Phone (262) 321-0110

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": "1674172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1992410203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10422 W HILLSIDE AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532222323",
            "telephone_number": "262-490-0756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11518 N PORT WASHINGTON RD STE 202",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923443",
            "telephone_number": "262-490-0756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILK",
        "first_name": "ALEXANDRA",
        "middle_name": "DUTTON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11074123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.