MRS. DONNA TINA MAY GLISSENDORF MSW, LCSW, CSAC
NPI 1306187240
Social Worker - Clinical in Fond Du Lac, WI

Q: What is Donna Glissendorf's NPI number?

The NPI number for Donna Glissendorf is 1306187240. It was assigned to this individual provider in the NPPES registry on March 1, 2013.

Q: What is Donna Glissendorf's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Donna Glissendorf was last updated on December 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 01, 2013PECOS EnrolledAccepts Medicare Assignment

430 E DIVISION ST, FOND DU LAC, WI 54935(920) 926-4200(920) 926-8933 Get Directions Write a Review

NPPES record last updated: December 3, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 3, 2020, Jan 27, 2020, Dec 27, 2016 (3 updates tracked since 2016).

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About Mrs. Donna Tina May Glissendorf Msw, Lcsw, Csac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. DONNA TINA MAY GLISSENDORF MSW, LCSW, CSAC (NPI 1306187240) is an individual clinical provider in Fond Du Lac, Wisconsin, licensed in Wisconsin (9255-123) and active in the NPI registry since March 2013. She is enrolled in Medicare PECOS, is affiliated with St. Agnes Hospital Hospice, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1306187240

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMRS. DONNA TINA MAY GLISSENDORFCredential: MSW, LCSW, CSAC

Location Address430 E DIVISION STFond Du Lac, WI 54935-4560

Mailing Address420 E Division StFond Du Lac, WI 54935-4560 · (920) 926-4200

Phone(920) 926-4200

Fax(920) 926-8933

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateMarch 1, 2013

Last NPPES UpdateDecember 3, 20203 updates tracked since enumeration

NPPES CertifiedDecember 3, 2020

✔ NPI 1306187240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in WI · 9255-123

Definition

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.

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 15953-132 (WI)

430 E DIVISION ST, Fond Du Lac, WI 54935

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Medica, Network Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Donna Tina May Glissendorf Msw, Lcsw, Csac is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID143656470

PECOS Enrollment IDI20200205002028

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Psychotherapy, 1 hour 90837

Psychotherapy is a therapeutic interaction or treatment between a trained professional and a patient. In a 1-hour session, you'll talk about your feelings, thoughts, and behaviors to help identify and manage mental health issues. This process aids in personal growth, healing, and improved well-being.

70 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St. Agnes Hospital Hospice

Acute Care Hospitals · Fond Du Lac, WI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520088

Location430 E Division StFond Du Lac, WI 54935 · Fond Du Lac County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54935 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $53.90 – $163.24

Typical copayment $0.00 (range $13.47 – $40.81)

Most-billed visit code NA

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CLAIRE ELIZABETH KRIZMAN

Counselor (Mental Health)