Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dereck Wolfgram, LCSW

Individual provider Clinical Social Worker · NPI 1174093744

Dereck Wolfgram, LCSW is a Clinical Social Worker in Oconomowoc, Wisconsin. Qualified in 2017, 9 years ago. Practices as a sole proprietor. Licensed in Wisconsin.

Years since qualifying
9
Licensed in
WI
In the registry since
2018
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Practice location Address checks out

1230 Corporate Center Dr Ste 100
Oconomowoc, WI 53066-4883
Phone: (262) 999-3495
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 9365-123 (WI)

Record details

NPI number1174093744
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedNovember 27, 2018
Last updated in NPPESFebruary 20, 2026
Certification dateFebruary 20, 2026
Mailing address1230 Corporate Center Dr Ste 100, Oconomowoc, WI 53066-4883

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Oconomowoc