Katie Jane Bartell, MA, LPC, SACIT
Individual provider Active NPI Professional Counselor · Shawano, WI
NPI 1124457460 · NPPES record last updated Oct 12, 2015
Key facts
- NPI
- 1124457460
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 5684-125 (WI)
- Practice address
- 504 Lakeland Rd
Shawano, WI 54166-3836 - Phone
- (715) 526-5547
- Fax
- (715) 526-5542
- NPI assigned
- Nov 7, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16798-130 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 1767-226 | WI | MD | Mental Health Counselor |
| 5684-125 | WI | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 16798-130 | WI | |
| Mental Health Counselor | 101YM0800X | 1767-226 | WI | |
| Professional Counselor | 101YP2500X | 5684-125 | WI | Yes |
Addresses
Primary practice location
504 Lakeland Rd
Shawano, WI 54166-3836
Mailing address
504 Lakeland Rd
Shawano, WI 54166-3836
Phone (715) 526-5547
Other names
- Ms. Katie Jane McCormick
Other providers in Shawano, WI
- Ashley Walsh and Associates, LLC
- Aurora Medical Group, Inc.
- Amanda E Baddmoccosin-Barnes
- Kerry L Baird
- Heather Lynn Bannister
- Elizabeth A Bartz
- Sarah Bauer
- Baycare Clinic LLP
- Anna Marie Beaumier
- Raul Beltran
All providers in Shawano, WI · Professional Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.