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RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA NPI 1205007796


NPI Information

NPI: 1205007796
Provider Name: RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA

Doing Business As: RED CLIFF COMMUNITY HEALTH CENTER

Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
88455 PIKE ROAD
BAYFIELD, WI
ZIP 54814
Phone: (715) 779-3707
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RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA is a clinical social worker in Bayfield, WI. The provider is 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. RED CLIFF BAND OF LAKE SUPERIOR CHIPPEWA NPI is 1205007796. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Red Cliff Community Health Center.

The provider's business location address is:

88455 PIKE ROAD
BAYFIELD, WI
ZIP 54814
Phone: (715) 779-3707
Fax: (715) 779-3711

The provider's authorized official is Patricia Ann Deragon-navarro .
The authorized official title is Health Administrator and has the following contact phone number (715) 779-3707.

The enumeration date for this NPI number is 3/12/2008 and was last updated on 3/12/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinical772-123WISCONSINYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
142200000OTHERWISCONSINMEDICAID-MENTAL HEALTH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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