Jennifer Skinner

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1194-226 Issued in WI

Practice address

125 N 6TH Ave
West Bend, WI 53095-3394

Phone

(262) 334-4340

Fax

(262) 334-4341

NPI assigned

Apr 19, 2012

Last updated

Apr 19, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2007

Medicare assignment

May accept Medicare assignment

Group practices

Kettle Moraine Counseling LLCGroup PAC ID 8527353747, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kettle Moraine Counseling LLC

  dba Kettle Moraine Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Bend, WI
  • NPI 1568790954
  Medicare reassignment Care Compare group NPD
• Affiliated Clinical Services Inc

  • Multi-Specialty Clinic/Center
  • West Bend, WI
  • NPI 1851473698
  NPD (past)
• Cedarburg Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Cedarburg, WI
  • NPI 1225040926
  NPD (past)

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334793600000",
    "number": "1063779700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N 6TH AVE",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530953394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N 6TH AVE",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530953394",
            "telephone_number": "262-334-4340",
            "fax_number": "262-334-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2012-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "1194-226",
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "WI",
            "license": "701197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Braden M Sims, DC
• Renee Sinopoli, MD
• Janet L Sivula, R.N.
• William James Skalecki
• Anne Marie Skalmoski, P.T.
• Benjamin T Skubal
• Jeffery R Smale, MD
• Dianne Marie Smith-O'Connor, LCSW
• Stephanie Rae Smith, CLC
• Baby Snigdha, MD

• Professional Counselor in West Bend, WI
• Providers in West Bend, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.