MS. SHELLY ROSE STATZ (NPI# 1235121260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235121260 |
| Entity Type | Individual |
| Full Name | MS. SHELLY ROSE STATZ |
| Credential | LCSW |
| Practice Address |
2910 Enloe St Hudson WI 54016-4538 |
| Mailing Address |
2925 Mondovi Rd Eau Claire WI 54701-6141 |
| Practice Telephone | 7153815437 |
| Practice Fax Number | 7153815438 |
| Mailing Telephone | 7158320238 |
| Mailing Fax Number | 7158320771 |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2016-06-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
7021-123 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CAQH | 114321498 | 01 |
| Street Address |
2910 ENLOE ST |
| City | HUDSON |
| State | WI |
| Zip Code | 54016-4538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033660840 | Renee L. Vannocker | Counselor | 2910 Enloe St, Ste 100, Hudson, WI 54016-4538 | 2016-10-17 |
| 1851643332 | Shannon Elizabeth Bartlett | Counselor | 2910 Enloe St, Hudson, WI 54016-4538 | 2012-10-09 |
| 1205130101 | Lindsay Kjolsing Sather | Counselor | 2910 Enloe St, Suite 104, Hudson, WI 54016-4538 | 2011-01-06 |
| 1710212394 | Kristine Hemauer | Psychologist | 2910 Enloe St, Suite 104, Hudson, WI 54016-4538 | 2009-10-15 |
| 1417180084 | Ashley J Hakes | Counselor | 2910 Enloe St, Suite 104, Hudson, WI 54016-4538 | 2009-08-31 |
| 1609005636 | Naomi Nicole Doriott | Counselor | 2910 Enloe St, Suite 104, Hudson, WI 54016-4538 | 2009-07-12 |
| 1124287032 | Amelia L Evans | Counselor | 2910 Enloe St, Suite 104, Hudson, WI 54016-4538 | 2008-06-05 |
| 1689778748 | Randi L Erickson | Psychologist | 2910 Enloe St, Hudson, WI 54016-8166 | 2006-09-11 |
| 1376659201 | Randi L. Erickson | Marriage & Family Therapist | 2910 Enloe St, Suite 104, Hudson, WI 54016-4538 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164921128 | Sara Lynn Henry | Occupational Therapy Assistant | 1320 Wisconsin St., Husdon, WI 54016 | 2018-02-06 |
| 1689003436 | Serving Hands Inc | Home Health | 1419 Boulder Court, Hudson, WI 54016 | 2013-11-02 |
| 1275973042 | Lisa Renee Haverly | Occupational Therapist | 477 Perch Lake Rd, Hudson, WI 54016 | 2013-06-26 |
| 1710320213 | Emily Ann Stevenson | Counselor | 901 4th St Ste 165, Hudson, WI 54016 | 2013-04-15 |
| 1083972954 | The Shurden Group | In Home Supportive Care | 2424 Monetary Blvd. #012, The Shurden Group Dba Comfort Keepers, Hudson, WI 54016 | 2012-04-30 |
| 1124305933 | Robert Michael Catlow-price | Massage Therapist | 131 Carmichael Road, Suite #202, Hudson, WI 54016 | 2011-11-08 |
| 1962780221 | Qin Chu | Acupuncturist | 1615 Maxwell Dr., Suite D, Hudson, WI 54016 | 2011-08-03 |
| 1124324231 | Hung Trieu Lieu | Acupuncturist | 1810 Crest View Dr Ste 4a, Hudson, WI 54016 | 2011-02-07 |
| 1912214966 | Sumac Residential LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 723 B Blue Jay Lane, Hudson, WI 54016 | 2010-09-10 |
| 1740593201 | Michelle Marie Young | Counselor | 2501 Hanley Road, Suite F, Eagle Valley Bank Building, Hudson, WI 54016 | 2010-07-26 |
| Find all providers in zip 54016 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609488634 | Megan Wrenn | Social Worker | 1211 County Road I, Hudson, WI 54016-6916 | 2020-08-20 |
| 1073122313 | Shannon Rae Speaks | Social Worker | 6933 Saint Regis Blvd, Hudson, OH 44236-3224 | 2020-07-22 |
| 1538781836 | Reagan Juliana Sottile | Social Worker | 11 Warren St, Hudson, NY 12534-3117 | 2020-05-11 |
| 1275187072 | Leah Hoffman | Social Worker | 2217 Vine St Ste 206, Hudson, WI 54016-5888 | 2019-07-30 |
| 1700445715 | Jennifer Turk | Social Worker | 1 Bradley Dr, Hudson, OH 44236-3035 | 2019-06-12 |
| 1508363623 | Jamie Gravelle | Social Worker | 69 Brigham St, Hudson, MA 01749-2787 | 2018-04-06 |
| 1164946109 | George J Bistany | Social Worker | 11 Winding Hollow Rd, Hudson, NH 03051-5115 | 2017-08-01 |
| 1558728873 | Lensie Lucas | Social Worker | 8715 Highway 690, Hudson, KY 40145-7631 | 2016-01-16 |
| 1184059636 | Emily Pitts | Social Worker | 168 Deer Creek Dr, Hudson, NC 28638-8919 | 2013-09-03 |
| 1356646806 | Heather Kristen Flowers | Social Worker | 7453 Mako Dr, Hudson, FL 34667-3968 | 2011-01-13 |
| Find all providers in HUDSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.