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Jacquelyn Mae Block, MFT, LCSW, LMFT

NPI 1336360429ActiveIndividual· Social Worker, Clinical· Fond Du Lac, WI

Social Worker, Clinical (MFT, LCSW, LMFT) with Agnesian Healthcare Inc, practicing in Fond Du Lac, Wisconsin. Medicare paid $6,332 for services to 11 patients in 2024. Lists Ssm Health St Agnes Hospital-Fond Du Lac as a hospital affiliation.

Overview

NPI1336360429
StatusActive
Entity typeIndividual
CredentialMFT, LCSW, LMFT
Sole proprietorNo
NPI issuedMay 2, 2007
Last updated in NPPESDec 16, 2020
Certified by providerDec 16, 2020

Specialties and licenses

TaxonomyCodeLicenseState
Social Worker, Clinical Primary1041C0700X2841-123WI
Marriage & Family Therapist106H00000X226-124WI

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Practitioner - Clinical Social Worker (WI)
Accepts assignmentYes (participating)

Medicare services in 2024

Medicare patients11
Services billed133 across 4 procedure codes
Paid by Medicare$6,332

Medicare sources and data years

Education and affiliations

Graduation year1990
Medicare specialtyClinical Social Worker
TelehealthOffers telehealth

Medical group

Hospital affiliation

Source: CMS Care Compare

Other clinical social workers in Fond Du Lac

All 31 clinical social workers in Fond Du Lac · All clinical social workers in Wisconsin