Julie Marie Carpenter

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5297-125 Issued in WI

Practice address

400 W River Dr
West Bend, WI 53090-1518

Phone

(262) 334-4340

NPI assigned

Jun 14, 2011

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

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

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Group practices

Kettle Moraine Counseling LLCGroup PAC ID 8527353747, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: juliecarpenter@tdh.allscriptsdirect.net

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.

• Kettle Moraine Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Bend, WI
  • NPI 1568790954

  WI

  Medicare reassignment Care Compare group NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD
• Affiliated Clinical Services Inc

  • Multi-Specialty Clinic/Center
  • West Bend, WI
  • NPI 1851473698
  NPD (past)

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1134414543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N47W7730 PARKLAND RD",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530122783",
            "telephone_number": "414-405-8776"
        },
        {
            "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": "530901518",
            "telephone_number": "262-334-4340"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N47W7730 Parkland Rd",
            "address_purpose": "LOCATION",
            "city": "Cedarburg",
            "state": "WI",
            "postal_code": "530122783",
            "country_code": "US",
            "telephone_number": "414-405-8776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "JULIE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "5297-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carey Cameron
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• Stephen Donald Cario, LPC-IT
• Paula Carlton, APNP
• Nichole Carstens, ATC, LAT
• Christina Cash, PHARMD, CAA
• Krystina Castillo
• CD Logistic Services
• Cedar Lake Dental Professionals LTD

• All providers in West Bend, WI
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.