NPIMap

Organization Active NPI

Wisconsin Lutheran Child & Family Service

  • Professional Counselor
  • Appleton, WI
National Provider Identifier
1043661036
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
WISCONSIN LUTHERAN CHILD & FAMILY SERVICE
Practice address
5300 N Meade St
Appleton, WI 54913-8383
Phone
(800) 438-1772
Fax
(262) 293-9737
NPI assigned
Jun 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Authorized official

Name
Mark Klug
Title
Ceo
Phone
(888) 685-9522

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

5300 N Meade St
Appleton, WI 54913-8383

Mailing address

W175N11120 Stonewood Dr
Attn Linda R
Germantown, WI 53022-6511
Phone (800) 438-1772

Other identifiers 1

IdentifierTypeStateIssuer
42171800MedicaidWI

Other names 1

  • Christian Family Counseling Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Christian Family Counseling62 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Locations

5300 N Meade St
Appleton, WI 54913

W175N11120 Stonewood Dr
#R
Germantown, WI 53022

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": "1467244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643932800000",
    "number": "1043661036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W175N11120 STONEWOOD DR",
            "address_2": "ATTN LINDA R",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530226511",
            "telephone_number": "800-438-1772",
            "fax_number": "262-293-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 N MEADE ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138383",
            "telephone_number": "800-438-1772",
            "fax_number": "262-293-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN LUTHERAN CHILD & FAMILY SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-30",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A",
        "authorized_official_last_name": "KLUG",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "888-685-9522"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42171800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Christian Family Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.