Individual provider Active NPI

Elizabeth Paasch, LPC

  • Professional Counselor
  • West Bend, WI
National Provider Identifier
1073866059
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4884-125 Issued in WI
Practice address
400 W River Dr
West Bend, WI 53090-1567
Phone
(262) 338-2717
Fax
(262) 338-9767
NPI assigned
Oct 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4884-125 WI Primary

Addresses

Primary practice location

400 W River Dr
West Bend, WI 53090-1567

Mailing address

400 W River Dr
West Bend, WI 53090-1567

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240306004223 WI Practitioner - Mental Health Counselor 5395181804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affiliated Clinical Services IncGroup PAC ID 0244124899, 22 clinicians

Practice addresses (Care Compare)

111 E Washington St
West Bend, WI 53095-2571
Phone (262) 338-2717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4884-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Clinical Services Inc CurrentSince Jan 22, 2024 Accepting new patients
Kettle Moraine Counseling LLC PastSince Jan 19, 2020 Accepting new patients

Locations

400 W River Dr
West Bend, WI 53090
Phone (262) 334-4340

111 E Washington St
West Bend, WI 53095
Phone (262) 338-2717

Organizations & group practices 2

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": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1073866059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W RIVER DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530901567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W RIVER DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530901567",
            "telephone_number": "262-338-2717",
            "fax_number": "262-338-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAASCH",
        "first_name": "ELIZABETH",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4884-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

Verify at the official NPI Registry.