ALAN SUMWALT PSYCHOTHERAPIES LLC — NPI 1528486263 (Licensed & Credentialed Behavioral Health & Social Service Providers

CMS-1500 Box 24J / 33a • NPI

1528486263

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

1041C0700X (CMS 80)

Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical

Box 32 Service Location & ZIP+4

146 PARK AVE, PEWAUKEE, WI, PEWAUKEE, WI, 53072-3410

✓ 9-Digit EDI 837 ZIP+4 (53072-3410)

Practice Phone & Referral Fax

(414) 588-6452

Fax: (262) 691-3005

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1528486263 (ALAN SUMWALT PSYCHOTHERAPIES LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1528486263` (NPI-2 Organization / Facility)
Provider / Legal Name	ALAN SUMWALT PSYCHOTHERAPIES LLC
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical NUCC Code: `1041C0700X` (Social Worker, Clinical)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	146 PARK AVE, PEWAUKEE, WI, PEWAUKEE, WI, 53072-3410
Practice Telephone / Fax	Tel: (414) 588-6452 \| Fax: (262) 691-3005
Administrative Mailing Address	146 PARK AVE, PEWAUKEE, WI, 53072-3410
Enumeration & Last Sync	Enumerated: 2014-03-31 \| CMS Record Updated: 2014-03-31
Authorized Official	ALAN SUMWALT (Director)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

146 PARK AVE, PEWAUKEE, WI, PEWAUKEE, WI, 53072-3410

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Plain-English Taxonomy & CMS Crosswalk (1041C0700X)

What Does Taxonomy Code 1041C0700X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1041C0700X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 80 (Licensed Clinical Social Worker)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Social Worker, Clinical for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ALAN SUMWALT PSYCHOTHERAPIES LLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261QM0850X` — Clinic/Center, Adult Mental Health Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: WI \| License: `346-123` \| Primary: Secondary
`1041C0700X` — Social Worker, Clinical Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical	State: WI \| License: `346-123` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ALAN SUMWALT PSYCHOTHERAPIES LLC (NPI #1528486263)