Individual provider Active NPI

Mari Ann Krueger, LPC

  • Professional Counselor
  • Oshkosh, WI
National Provider Identifier
1073640736
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3465 125 Issued in WI
Practice address
404 N Main St Ste 612
Oshkosh, WI 54901-4953
Phone
(920) 385-1420
Fax
(866) 327-3295
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3465 125 WI
Registered Nurse 163W00000X 106595030 WI
Professional Counselor 101YP2500X 3465 125 WI Primary

Addresses

Primary practice location

404 N Main St Ste 612
Oshkosh, WI 54901-4953

Mailing address

PO Box 282
Black Creek, WI 54106-0282
Phone (920) 385-5076

Other identifiers 1

IdentifierTypeStateIssuer
43595200MedicaidWI

Other names 1

  • Mari Anne Hogan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3465 125WIMDMental Health Counselor
106595030WIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Integrity Counseling, LLC CurrentSince Dec 21, 2021 Accepting new patients

Locations

404 N Main St
Ste 612
Oshkosh, WI 54901
Phone (920) 385-1420

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1073640736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 282",
            "city": "BLACK CREEK",
            "state": "WI",
            "postal_code": "541060282",
            "telephone_number": "920-385-5076",
            "fax_number": "866-327-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 N MAIN ST STE 612",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549014953",
            "telephone_number": "920-385-1420",
            "fax_number": "866-327-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "MARI",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "3465 125",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "106595030",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3465 125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43595200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARI",
            "last_name": "HOGAN",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.