Individual provider Active NPI

Kristin Weber

  • Professional Counselor
  • West Milwaukee, WI
National Provider Identifier
1134547276
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5964-125 Issued in WI
Practice address
1610 Miller Park Way
West Milwaukee, WI 53214-3604
Phone
(414) 672-3801
Fax
(414) 672-6026
NPI assigned
Apr 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5964-125 WI Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 17186-130 WI

Addresses

Primary practice location

1610 Miller Park Way
West Milwaukee, WI 53214-3604

Mailing address

1610 Miller Park Way
West Milwaukee, WI 53214-3604
Phone (414) 672-3801

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
17186-130WIMDAddiction (Substance Use Disorder) Counselor
5964-125WIMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1396656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1134547276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 MILLER PARK WAY",
            "city": "WEST MILWAUKEE",
            "state": "WI",
            "postal_code": "532143604",
            "telephone_number": "414-672-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 MILLER PARK WAY",
            "city": "WEST MILWAUKEE",
            "state": "WI",
            "postal_code": "532143604",
            "telephone_number": "414-672-3801",
            "fax_number": "414-672-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-05",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5964-125",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17186-130",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.