Donna Tina May Glissendorf, MSW, LCSW, CSAC
NPI 1306187240ActiveIndividual· Social Worker, Clinical· Fond Du Lac, WI
Social Worker, Clinical (MSW, LCSW, CSAC) with Agnesian Healthcare Inc, practicing in Fond Du Lac, Wisconsin. Medicare paid $7,170 for services to 14 patients in 2024. Lists Ssm Health St Agnes Hospital-Fond Du Lac as a hospital affiliation.
Overview
| NPI | 1306187240 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MSW, LCSW, CSAC |
| Sole proprietor | No |
| NPI issued | Mar 1, 2013 |
| Last updated in NPPES | Dec 3, 2020 |
| Certified by provider | Dec 3, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 9255-123 | WI |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | 15953-132 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (WI) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 14 |
|---|---|
| Services billed | 107 across 5 procedure codes |
| Paid by Medicare | $7,170 |
Education and affiliations
| Graduation year | 2016 |
|---|---|
| Medicare specialty | Clinical Social Worker |
| Telehealth | Offers telehealth |
Medical group
- Agnesian Healthcare IncWaupun, WI · 388 clinicians
Hospital affiliation
- Ssm Health St Agnes Hospital-Fond Du LacFond Du Lac, WI
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All 31 clinical social workers in Fond Du Lac · All clinical social workers in Wisconsin