Active NPI
KB Counseling & Emdr LLC
Doing business as KB Psychotherapy & EMDR
- Addiction (Substance Use Disorder) Counselor
- Bristol, WI
National Provider Identifier
1063993038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 16105-131
- Legal business name
- KB COUNSELING & EMDR LLC
- Doing business as
- KB Psychotherapy & EMDR
- Practice address
- 7918 Fredricksburg CT Unit 101
Bristol, WI 53104-8720 - Phone
- (262) 806-1467
- Fax
- (262) 661-7702
- NPI assigned
- Aug 27, 2018
- Last updated
- Apr 1, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kate M Bullard, MS
- Title
- Owner/Psychotherapist
- Phone
- (847) 809-9218
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 16105-131 | WI | Primary |
| Professional Counselor | 101YP2500X | 6363-125 | WI |
Addresses
Primary practice location
7918 Fredricksburg CT Unit 101
Bristol, WI 53104-8720
Mailing address
7918 Fredricksburg CT Unit 101
Bristol, WI 53104-8720
Phone (262) 806-1467
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100039774 | Medicaid | WI |
Other names 1
- KB Psychotherapy & EMDR
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
647 W Main St
Lake Geneva, WI 53147
Phone (262) 441-0285
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Counselor
- Gulfport, FL
- NPI 1033550934
Addiction (Substance Use Disorder), WI
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535328000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1775001600000",
"number": "1063993038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7918 FREDRICKSBURG CT UNIT 101",
"city": "BRISTOL",
"state": "WI",
"postal_code": "531048720",
"telephone_number": "262-806-1467",
"fax_number": "262-661-7702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7918 FREDRICKSBURG CT UNIT 101",
"city": "BRISTOL",
"state": "WI",
"postal_code": "531048720",
"telephone_number": "262-806-1467",
"fax_number": "262-661-7702"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KB COUNSELING & EMDR LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-08-27",
"last_updated": "2026-04-01",
"certification_date": "2026-04-01",
"status": "A",
"authorized_official_last_name": "BULLARD",
"authorized_official_first_name": "KATE",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
"authorized_official_telephone_number": "847-809-9218",
"authorized_official_credential": "MS"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "16105-131",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "6363-125",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100039774",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "KB Psychotherapy & EMDR",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Bristol, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.