NPIMap

Organization Active NPI

Im Fine Counseling Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Atkinson, WI
National Provider Identifier
1023642725
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
IM FINE COUNSELING SERVICES LLC
Practice address
20 Sherman Ave E
Fort Atkinson, WI 53538-1864
Phone
(920) 728-1810
NPI assigned
Mar 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Authorized official

Name
Mr. Donald L Reynolds, LPC CSACNPI 1922591254
Title
Psychotherapist/ Owner
Phone
(920) 728-1810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

20 Sherman Ave E
Fort Atkinson, WI 53538-1864

Mailing address

20 Sherman Ave E
Fort Atkinson, WI 53538-1864
Phone (920) 728-1810

National Provider Directory

National Provider Directory

Locations

20 Sherman Ave E
Fort Atkinson, WI 53538
Phone (920) 728-1810

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1023642725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SHERMAN AVE E",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381864",
            "telephone_number": "920-728-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SHERMAN AVE E",
            "city": "FORT ATKINSON",
            "state": "WI",
            "postal_code": "535381864",
            "telephone_number": "920-728-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IM FINE COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-03",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST/ OWNER",
        "authorized_official_telephone_number": "920-728-1810",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC CSAC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Atkinson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.