Kyle Konkol, LPC-IT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

2510 E Capitol Dr
Shorewood, WI 53211-2136

Phone

(414) 507-2944

NPI assigned

Nov 25, 2024

Last updated

Nov 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1063238046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4529 N BARTLETT AVE",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532111510",
            "telephone_number": "414-507-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 E CAPITOL DR",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112136",
            "telephone_number": "414-507-2944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4529 N Bartlett Ave",
            "address_purpose": "LOCATION",
            "city": "Shorewood",
            "state": "WI",
            "postal_code": "532111510",
            "country_code": "US",
            "telephone_number": "414-507-2944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KONKOL",
        "first_name": "KYLE",
        "credential": "LPC-IT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Shorewood, WI
• Providers in Shorewood, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.