Individual provider Active NPI

Kristen Kathryn Johnson, LPC

  • Professional Counselor
  • Wausau, WI
National Provider Identifier
1033991336
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
12152-125 Issued in WI
Practice address
2620 Stewart Ave Ste 310
Wausau, WI 54401-4162
Phone
(715) 848-0525
Fax
(715) 848-8665
NPI assigned
Oct 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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 12152-125 WI Primary
Professional Counselor 101YP2500X 7667-226 WI

Addresses

Primary practice location

2620 Stewart Ave Ste 310
Wausau, WI 54401-4162

Mailing address

2620 Stewart Ave Ste 310
Wausau, WI 54401-4162
Phone (715) 848-0525

Other identifiers 2

IdentifierTypeStateIssuer
7667-226OtherWILICENSE
12152-125OtherWISTATELICENSE

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
I20251119001093 WI Practitioner - Mental Health Counselor 0143711960 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charis Counseling LLCGroup PAC ID 1456244276, 13 clinicians

Practice addresses (Care Compare)

2620 Stewart Ave
Suite 310
Wausau, WI 54401-4162
Phone (715) 848-0525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12152-125WIMDProfessional Counselor
7667-226WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Charis Counseling, LLC Professional CurrentSince Oct 28, 2025 Accepting new patients

Locations

101 W McMillan St
Ste 2B
Marshfield, WI 54449
Phone (715) 389-9382

2620 Stewart Ave
Ste 310
Wausau, WI 54401
Phone (715) 848-0525

Organizations & group practices 1

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": "1697760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1033991336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 STEWART AVE STE 310",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014162",
            "telephone_number": "715-848-0525",
            "fax_number": "715-848-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 STEWART AVE STE 310",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014162",
            "telephone_number": "715-848-0525",
            "fax_number": "715-848-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KRISTEN",
        "middle_name": "KATHRYN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-20",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "12152-125",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7667-226",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "7667-226",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATELICENSE",
            "identifier": "12152-125",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.