Individual provider Active NPI

Katherine Kirchner, LPC

  • Professional Counselor
  • Appleton, WI
National Provider Identifier
1083236178
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4856-125 Issued in WI
Practice address
1636 W Homestead Dr
Appleton, WI 54914-2026
Phone
(608) 628-5370
NPI assigned
May 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

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 4856-125 WI Primary

Addresses

Primary practice location

1636 W Homestead Dr
Appleton, WI 54914-2026

Mailing address

1636 W Homestead Dr
Appleton, WI 54914-2026
Phone (608) 628-5370

Other names 1

  • Katherine Collentine 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
4856-125WIMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1083236178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 W HOMESTEAD DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549142026",
            "telephone_number": "608-628-5370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 W HOMESTEAD DR",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549142026",
            "telephone_number": "608-628-5370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRCHNER",
        "first_name": "KATHERINE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-11",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4856-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "COLLENTINE",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; 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.