Individual provider Active NPI

Rebecca Kosewski, LPC

  • Professional Counselor
  • Marinette, WI
National Provider Identifier
1013550813
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8411-125 Issued in WI
Practice address
2500 Hall Ave Ste a
Marinette, WI 54143-1656
Phone
(715) 732-7760
NPI assigned
Oct 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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 8411-125 WI Primary
Professional Counselor 101YP2500X 4425-226 WI

Addresses

Primary practice location

2500 Hall Ave Ste a
Marinette, WI 54143-1656

Mailing address

2500 Hall Ave Ste a
Marinette, WI 54143-1656

Other names 1

  • Rebecca Moody Former name

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
I20260609002837 WI Practitioner - Mental Health Counselor 0648741793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of MarinetteGroup PAC ID 3476513177, 4 clinicians

Practice addresses (Care Compare)

2500 Hall Ave
Suite a
Marinette, WI 54143-1656
Phone (715) 732-7714

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4425-226WIMDProfessional Counselor
8411-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
County of Marinette Past Accepting new patients

Organizations & group practices 2

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": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1013550813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 HALL AVE STE A",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HALL AVE STE A",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431656",
            "telephone_number": "715-732-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSEWSKI",
        "first_name": "REBECCA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-24",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8411-125",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4425-226",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "MOODY",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marinette, WI

Sources for this page

Verify at the official NPI Registry.