Kiersten Lynette Buck, LPC, SAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

7631-25 Issued in WI

Practice address

800 Wilson Ave RM 330
Menomonie, WI 54751-2746

Phone

(715) 256-7166

NPI assigned

Jan 25, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kiersten Lynette Jablonicky Former name

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

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Group practices

Thrive Psychological and Consulting Services LLCGroup PAC ID 7810470853, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Thrive Psychological and Consulting Services LLC

  • Professional Counselor
  • Menomonie, WI
  • NPI 1487383808
  Medicare reassignment Care Compare group NPD
• Enigma Psychological Inc.

  • Social Worker
  • Fall Creek, WI
  • NPI 1811407059
  NPD
• Family Therapy Associates, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New Richmond, WI
  • NPI 1215239736
  NPD
• Collaborative Counseling LLC

  • Mental Health Counselor
  • Maple Grove, MN
  • NPI 1598034324
  NPD
• Jackie Nitschke Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • Green Bay, WI
  • NPI 1265642318
  NPD (past)

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1003314907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WILSON AVE RM 330",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512746",
            "telephone_number": "715-256-7166",
            "fax_number": "888-427-8048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WILSON AVE RM 330",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512746",
            "telephone_number": "715-256-7166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3610 Oakwood Mall Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Eau Claire",
            "state": "WI",
            "postal_code": "547019084",
            "country_code": "US",
            "telephone_number": "715-246-4840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCK",
        "first_name": "KIERSTEN",
        "middle_name": "LYNETTE",
        "credential": "LPC, SAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-25",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "18178-130",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7631-25",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIERSTEN",
            "last_name": "JABLONICKY",
            "middle_name": "LYNETTE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tara Marie Bridgeman, PHARM.D.
• Abby N Bristlin, COTA
• Victoria Broses, MS
• Steven G. Brown, M.D.
• Tammy G Buchanan, CRNA
• Kristie L Bugs, MS LCSW
• Jolee Buhr, CSAC
• Kyle J Burkhamer, PA
• Amy M Burns, PA-C
• Katrina Burnside

• Professional Counselor in Menomonie, WI
• Providers in Menomonie, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.