NPIMap

Organization Active NPI

Appleton Psychiatric & Counseling Center

  • Clinical Social Worker
  • Appleton, WI
National Provider Identifier
1992858179
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
802 123 Issued in WI
Legal business name
APPLETON PSYCHIATRIC & COUNSELING CENTER
Practice address
477 S Nicolet Rd
Appleton, WI 54914-8270
Phone
(920) 882-6610
Fax
(920) 882-6611
NPI assigned
Jan 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Victoria A Gossens, MSW, LCSW
Title
Psychotherapist
Phone
(920) 882-6610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 802 123 WI Primary

Addresses

Primary practice location

477 S Nicolet Rd
Appleton, WI 54914-8270

Mailing address

477 S Nicolet Rd
Appleton, WI 54914-8270
Phone (920) 882-6610

Other identifiers 1

IdentifierTypeStateIssuer
39625900MedicaidWI

National Provider Directory

National Provider Directory

Locations

477 S Nicolet Rd
Appleton, WI 54914
Phone (920) 450-8988

1531 S Madison St
Ste 530
Appleton, WI 54915
Phone (920) 738-2953

340 N Wisconsin St
De Pere, WI 54115
Phone (920) 738-2953

W9449 Givens Rd
Hortonville, WI 54944
Phone (920) 779-3900

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992858179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 S NICOLET RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549148270",
            "telephone_number": "920-882-6610",
            "fax_number": "920-882-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 S NICOLET RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549148270",
            "telephone_number": "920-882-6610",
            "fax_number": "920-882-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLETON PSYCHIATRIC & COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOSSENS",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "920-882-6610",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "802 123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39625900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.