Kathleen Mary Kowalke, LPC, CTRS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

11075-125 Issued in WI

Practice address

1825 Riverside Dr
Green Bay, WI 54301-2316

Phone

(920) 272-8220

Fax

(651) 323-2648

NPI assigned

May 14, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 21, 2026 through Apr 21, 2028

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Catholic Charities of the Diocese of Green Bay Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1376769117
  NPD

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1093564064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 PARKRIDGE AVE",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431529",
            "telephone_number": "262-352-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 RIVERSIDE DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012316",
            "telephone_number": "920-272-8220",
            "fax_number": "651-323-2648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 Hall Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Marinette",
            "state": "WI",
            "postal_code": "541431062",
            "country_code": "US",
            "telephone_number": "920-272-8234",
            "fax_number": "651-323-2648",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 Main St",
            "address_purpose": "LOCATION",
            "city": "Wrightstown",
            "state": "WI",
            "postal_code": "541801057",
            "country_code": "US",
            "telephone_number": "920-272-8234",
            "fax_number": "651-323-2648",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "W2035 County Rd S",
            "address_purpose": "LOCATION",
            "city": "Freedom",
            "state": "WI",
            "postal_code": "541307565",
            "country_code": "US",
            "telephone_number": "920-272-8234",
            "fax_number": "651-323-2648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOWALKE",
        "first_name": "KATHLEEN",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "LPC, CTRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-14",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "11075-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Joseph Koszuta, M.D.
• Lauren Koth
• Nicole Kotila, RPH
• Kristin C Kouba, MSW, APSW
• Eugeni T Kouzov, M.D.
• Julianne Kowalski
• Jane Elizabeth Kozicki, RN
• Jacob A Kozisek, OD
• Eileen Kozlovsky
• Nicole Kozlovsky

• Professional Counselor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.