KELLY JEAN WITT-ERICKSON (NPI# 1801106265) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801106265 |
| Entity Type | Individual |
| Full Name | KELLY JEAN WITT-ERICKSON |
| Credential | ICSW CPC |
| Practice Address |
548 North Lake Avenue Phillips WI 54555 |
| Mailing Address |
W5213 Worcester Lake Road Prentice WI 54556 |
| Practice Telephone | 7153396453 |
| Mailing Telephone | 7153600809 |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2010-10-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
3898-123 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 39706000 | 05 |
| Street Address |
548 NORTH LAKE AVENUE |
| City | PHILLIPS |
| State | WI |
| Zip Code | 54555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356971162 | Tully Erwin | Pharmacist | 256 South Lave Avenue, Phillips, WI 54555 | 2020-01-21 |
| 1326494543 | New Horizons North, Inc. | Voluntary or Charitable | 1215 N Airport Rd, Phillips, WI 54555 | 2016-05-06 |
| 1629215314 | Roepke Physical Therapy Limited Partnership | Occupational Therapist | N 9691 Highway 13 N, Phillips, WI 54555 | 2009-01-16 |
| 1598922429 | Counseling & Development Center, Inc | Community/Behavioral Health | 171 Chestnut Street, Phillips, WI 54555 | 2008-05-19 |
| 1518134568 | Central Price Co Ambulance Service, Inc | Ambulance | 104c N Argyle, Phillips, WI 54555 | 2008-05-09 |
| 1235304395 | School District of Phillips | Local Education Agency (LEA) | 365 Highway 100, Phillips, WI 54555 | 2008-04-29 |
| 1942473780 | Haven House Community Support Center of Price County | Community/Behavioral Health | 548 N Lake Ave, Phillips, WI 54555 | 2008-04-11 |
| 1295947109 | Northern Sight Vision Clinic, LLC | Optometrist | 104a N. Argyle Ave, Phillips, WI 54555 | 2007-05-04 |
| 1902028541 | County of Price | Public Health or Welfare | 104 S Eyder Avenue, Phillips, WI 54555 | 2007-05-03 |
| 1770703035 | Lori A Severson | Chiropractor | 104-c North Argyle Avenue, Phillips, WI 54555 | 2007-04-27 |
| Find all providers in zip 54555 | ||||
| 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 |
|---|---|---|---|---|
| 1780616367 | Theresa Ann Yant-warnke | Social Worker | 121 Riverview Dr, Phillips, NE 68865-1727 | 2006-07-06 |
| 1285892414 | Pamela Marie Olson | Social Worker | 548 N Lake Ave, Phillips, WI 54555-1028 | 2008-05-23 |
| 1609034834 | Michelle J Schmidt | Social Worker | 548 N Lake Ave, Phillips, WI 54555-1028 | 2008-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306446257 | Richard Harry Goldberg | Social Worker | 1514 Wood Ln, Madison, WI 53705-1457 | 2020-10-29 |
| 1710586219 | Megan Beckler | Social Worker | 49 Kessel Ct Bldg 25, Madison, WI 53711-6200 | 2020-10-26 |
| 1912506908 | Compassionate Clinical Services, LLC | Social Worker | 1314 S 1st St # 210, Milwaukee, WI 53204-2405 | 2020-10-20 |
| 1326655564 | Ryan Joseph Jones | Social Worker | 904 Angelo Rd, Sparta, WI 54656-1416 | 2020-09-30 |
| 1841805033 | Alyssa Kress | Social Worker | 3805 Mount View Ave Apt 17, Weston, WI 54476-6449 | 2020-09-14 |
| 1659986560 | Association of Community Empowerment, LLC | Social Worker | 3500 N Sherman Blvd Ste 303, Milwaukee, WI 53216-3463 | 2020-09-09 |
| 1316550205 | Ellice Plant | Social Worker | 2643 N Newhall St, Milwaukee, WI 53211-3517 | 2020-08-28 |
| 1609488634 | Megan Wrenn | Social Worker | 1211 County Road I, Hudson, WI 54016-6916 | 2020-08-20 |
| 1801407895 | Maxine Fran Rabinowe | Social Worker | 1943 N Summit Ave Apt 14, Milwaukee, WI 53202-1386 | 2020-08-12 |
| 1275143521 | Sara Kay Zwieg | Social Worker | 851 Rogers St, Milton, WI 53563-1767 | 2020-08-02 |
| Find all providers with the same taxonomy | ||||
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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.