Katherine Diane Collins, LCSW 06/13-18
Individual provider Active NPI Mental Health Counselor · Mukwonago, WI
NPI 1134613656 · NPPES record last updated Jun 18, 2018
Key facts
- NPI
- 1134613656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 8942-123 (WI)
- Practice address
- 400 Bay View Rd Ste C
Mukwonago, WI 53149-1770 - Phone
- (262) 789-1191
- Fax
- (262) 363-7289
- NPI assigned
- Jun 18, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 19
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aspirus Rhinelander and Tomahawk Hospitals and Clinics, Inc.
Practice addresses (Care Compare)
1630 Chippewa Dr
Rhinelander, WI 54501-9503
Phone (715) 361-5480
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190304000202 | WI | Practitioner - Clinical Social Worker | 2264771690 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. | Current |
Accepting new patients | |
| Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. | Current |
Accepting new patients | |
| Cornerstone Counseling Services, Inc | Mental Health | Past |
Accepting new patients |
Locations
29980 Network Pl
Chicago, IL 60673
400 W Glen St
Crandon, WI 54520
Phone (715) 478-3318
1630 N Chippewa Dr
Rhinelander, WI 54501
Phone (715) 361-5480
2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074
401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 8942-123 | WI | Yes |
Addresses
Primary practice location
400 Bay View Rd Ste C
Mukwonago, WI 53149-1770
Mailing address
N7269 Colbo Rd
Burlington, WI 53105-2525
Phone (262) 749-8687
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42170300 | Medicaid | WI |
Other names
- Katey Collins
Other providers in Mukwonago, WI
- Eric Carlton
- Chiropractic Firsts.C.
- Crysta Clark
- Sarah Cleaver
- Stephanie L Coates-McFeeley
- Kirsten Sarah Collins
- Michael F Connor
- Jennifer Jean Cook
- Jean Cottrell
- Kathryn Craig
All providers in Mukwonago, WI · Mental Health 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 Jun 18, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.