Active NPI
La Shanda Tolefree, BA, MS
- Professional Counselor
- Kenosha, WI
National Provider Identifier
1003350422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 8095-125
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100227567 | Medicaid | WI | |
| 17018131 | Other | WI | SUBSTANCE ABUSE COUNSELOR |
| 8095125 | Other | WI | LICENSED 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 17018131 | WI | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Authentic Conversations Therapeutic Services | Professional | Current | Accepting new patients |
| Kenosha Human Development Services, Inc | Current | 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.
-
- Professional Counselor
- Kenosha, WI
- NPI 1851165575
-
- Case Management Agency
- Kenosha, WI
- NPI 1104622620
-
- Adult Mental Health Clinic/Center
- Kenosha, WI
- NPI 1326179987
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; 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.