MRS. MICHELLE K RUSBOLDT LCSW
NPI 1366817165
Social Worker - Clinical in Two Rivers, WI

Active since December 04, 2015PECOS EnrolledAccepts Medicare Assignment
5300 MEMORIAL DR, TWO RIVERS, WI 54241(920) 793-7420 Get Directions Write a Review

NPPES record last updated: December 8, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 8, 2021, Mar 17, 2018, Dec 4, 2015 (3 updates tracked since 2015).

About Mrs. Michelle K Rusboldt Lcsw NPPES

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

MRS. MICHELLE K RUSBOLDT LCSW (NPI 1366817165) is an individual clinical provider in Two Rivers, Wisconsin, licensed in Wisconsin (127961-121) and active in the NPI registry since December 2015. She is enrolled in Medicare PECOS, maintains a secondary practice location in Green Bay, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1366817165
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMRS. MICHELLE K RUSBOLDTCredential: LCSW
Location Address5300 MEMORIAL DRTwo Rivers, WI 54241-3923
Mailing Address5300 Memorial DrTwo Rivers, WI 54241-3923 · (920) 793-7420
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateDecember 4, 2015
Last NPPES UpdateDecember 8, 20213 updates tracked since enumeration
NPPES CertifiedDecember 8, 2021
NPI 1366817165 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in WI · 127961-121
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.

5300 MEMORIAL DR, Two Rivers, WI 54241

Other Names 1

Former Name (1)Michelle Kristine Backhaus

Secondary Practice Location 1

Location 12851 University AveGreen Bay, WI 54311-5855 · Phone (920) 431-2500 ext. 2492

Accepted 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. Michelle K Rusboldt Lcsw 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 ID4082974126
PECOS Enrollment IDI20180209000020
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 2

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 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.
129 services23 patients
Psychotherapy, 45 minutes 90834
Psychotherapy is a treatment method where you converse with a therapist about your thoughts, feelings, and behaviors. In a 45-minute session, the therapist assists you in understanding and managing your mental health concerns, improving emotional wellness, and promoting personal growth.
43 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54241 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.

Nurse Practitioner
5300 MEMORIAL DR
TWO RIVERS, WI 54241
Audiologist
5300 MEMORIAL DR
TWO RIVERS, WI 54241
Pharmacist
5300 MEMORIAL DR, SUITE 103
TWO RIVERS, WI 54241
Occupational Therapist
5300 MEMORIAL DR
TWO RIVERS, WI 54241
Physical Therapist
5300 MEMORIAL DR
TWO RIVERS, WI 54241
Physical Therapy Assistant
5300 MEMORIAL DR
TWO RIVERS, WI 54241
Registered Nurse (Diabetes Educator)
5300 MEMORIAL DR
TWO RIVERS, WI 54241
Occupational Therapist
5300 MEMORIAL DR
TWO RIVERS, WI 54241

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1366817165, enumerated as an "individual" on December 04, 2015.

The provider is located at 5300 MEMORIAL DR TWO RIVERS, WI 54241 and the phone number is (920) 793-7420.

Social Worker with taxonomy code 1041C0700X and a focus in Clinical.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Aspirus Health. Please consult your insurance carrier or call the provider to verify.