Individual provider Active NPI

La Shanda Tolefree, BA, MS

  • Professional Counselor
  • Kenosha, WI
National Provider Identifier
1003350422
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8095-125 Issued in WI
Practice address
7445 20TH Ave
Kenosha, WI 53143-5373
Phone
(262) 358-3500
Fax
(262) 360-2443
NPI assigned
Dec 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 17018131 WI
Professional Counselor 101YP2500X 8095-125 WI Primary

Addresses

Primary practice location

7445 20TH Ave
Kenosha, WI 53143-5373

Mailing address

PO Box 1013
Kenosha, WI 53141-1013
Phone (262) 358-3500

Other identifiers 3

IdentifierTypeStateIssuer
100227567MedicaidWI
17018131OtherWISUBSTANCE ABUSE COUNSELOR
8095125OtherWILICENSED PROFESSIONAL COUNSELOR

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
I20240603001987 WI Practitioner - Mental Health Counselor 1951774405

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

7445 20TH Ave
Kenosha, WI 53143-5373

PO Box
Suite 1013
Kenosha, WI 53141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17018131WIMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Authentic Conversations Therapeutic Services Professional CurrentSince Mar 11, 2025 Accepting new patients
Kenosha Human Development Services, Inc CurrentSince Mar 11, 2025 Accepting new patients
Mathew McCarthy, MD, SC Past Accepting new patients

Locations

7445 20th Ave
Kenosha, WI 53143
Phone (414) 533-5915

3536 52nd St
Kenosha, WI 53144
Phone (262) 764-8555

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1003350422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1013",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531411013",
            "telephone_number": "262-358-3500",
            "fax_number": "262-360-2443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7445 20TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435373",
            "telephone_number": "262-358-3500",
            "fax_number": "262-360-2443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLEFREE",
        "first_name": "LA SHANDA",
        "credential": "BA, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-05",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17018131",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8095-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100227567",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUBSTANCE ABUSE COUNSELOR",
            "identifier": "17018131",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR",
            "identifier": "8095125",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.