Individual provider Active NPI

Louise Clara Daul, MS, LPC

  • Professional Counselor
  • Green Bay, WI
National Provider Identifier
1003051152
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4989-125 Issued in WI
Practice address
123 N Oakland Ave
Green Bay, WI 54303-2831
Phone
(920) 770-4088
Fax
(651) 705-0026
NPI assigned
Dec 3, 2008
Last updated
Nov 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 585-226 WI
Professional Counselor 101YP2500X 4989-125 WI Primary

Addresses

Primary practice location

123 N Oakland Ave
Green Bay, WI 54303-2831

Mailing address

123 N Oakland Ave
Green Bay, WI 54303-2831
Phone (920) 770-4088

Other identifiers 1

IdentifierTypeStateIssuer
100001242MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260331003787 WI Practitioner - Mental Health Counselor 8527201300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Power for Change LLCGroup PAC ID 0840571253, 3 clinicians

Practice addresses (Care Compare)

123 N Oakland Ave
Green Bay, WI 54303-2831
Phone (920) 770-4088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4989-125WIMDProfessional Counselor
585-226WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Power for Change, LLC CurrentSince Oct 17, 2021 Accepting new patients

Locations

123 N Oakland Ave
Green Bay, WI 54303
Phone (920) 770-4088

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1003051152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 N OAKLAND AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032831",
            "telephone_number": "920-770-4088",
            "fax_number": "651-705-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N OAKLAND AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032831",
            "telephone_number": "920-770-4088",
            "fax_number": "651-705-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUL",
        "first_name": "LOUISE",
        "middle_name": "CLARA",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-03",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "585-226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4989-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100001242",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.