Individual provider Active NPI

Elissa L Stults, LMFT

  • Marriage & Family Therapist
  • Waupaca, WI
National Provider Identifier
1043527799
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
844-124 Issued in WI
Practice address
750 Bowling LN
Waupaca, WI 54981-7707
Phone
(157) 201-2758
Fax
(715) 204-7151
NPI assigned
Sep 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 844-124 WI Primary

Addresses

Primary practice location

750 Bowling LN
Waupaca, WI 54981-7707

Mailing address

750 Bowling LN
Waupaca, WI 54981-7707
Phone (715) 201-2758

Other names 1

  • Elissa Leonora Achten Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 5, 2026 through Jan 5, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
844-124WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sherman Counseling Management, S.C. PastSince Apr 1, 2024 Accepting new patients

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": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1043527799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 BOWLING LN",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549817707",
            "telephone_number": "715-201-2758",
            "fax_number": "715-204-7151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 BOWLING LN",
            "city": "WAUPACA",
            "state": "WI",
            "postal_code": "549817707",
            "telephone_number": "157-201-2758",
            "fax_number": "715-204-7151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STULTS",
        "first_name": "ELISSA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "844-124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISSA",
            "last_name": "ACHTEN",
            "middle_name": "LEONORA",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waupaca, WI

Sources for this page

Verify at the official NPI Registry.