NPIMap

Organization Active NPI

County of Adams

  • Mental Health Counselor
  • Friendship, WI
National Provider Identifier
1104930866
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1253 Issued in WI
Legal business name
COUNTY OF ADAMS
Practice address
108 E North St
Friendship, WI 53934-9443
Phone
(608) 339-4505
Fax
(608) 339-4593
NPI assigned
Aug 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Authorized official

Name
Wendy Pierce
Title
Fiscal Manager
Phone
(608) 339-4505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 1253 WI Primary

Addresses

Primary practice location

108 E North St
Friendship, WI 53934-9443

Mailing address

108 E North St
Friendship, WI 53934-9443
Phone (608) 339-4505

Other identifiers 4

IdentifierTypeStateIssuer
43109000MedicaidWI
42117800MedicaidWI
43079900MedicaidWI
43070000MedicaidWI

Other names 1

  • Adams County Health & Human Services Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050929000321 WI Part B Supplier - Clinic/Group Practice 2567493810 Receives reassigned benefits from 5 practitioners
Practice locations: Friendship, WI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Adams County Health and Human Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1104930866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 E NORTH ST",
            "city": "FRIENDSHIP",
            "state": "WI",
            "postal_code": "539349443",
            "telephone_number": "608-339-4505",
            "fax_number": "608-339-4593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 E NORTH ST",
            "city": "FRIENDSHIP",
            "state": "WI",
            "postal_code": "539349443",
            "telephone_number": "608-339-4505",
            "fax_number": "608-339-4593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF ADAMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "FISCAL MANAGER",
        "authorized_official_telephone_number": "608-339-4505"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "1253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43109000",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42117800",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43079900",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43070000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adams County Health & Human Services Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Adams County Health & Human Services Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Friendship, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.