Organization Active NPI

KB Counseling & Emdr LLC

Doing business as KB Psychotherapy & EMDR

  • Addiction (Substance Use Disorder) Counselor
  • Bristol, WI
National Provider Identifier
1063993038
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
16105-131 Issued in WI
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, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
100039774MedicaidWI

Other names 1

  • KB Psychotherapy & EMDR Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260617000775 WI Part B Supplier - Clinic/Group Practice 8426520818 Receives reassigned benefits from 1 practitioner
Practice locations: Bristol, WI

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.