Active NPI
Kevin Wysocki
- Counselor
- Brookfield, WI
National Provider Identifier
1154045474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 7060-226
- Practice address
- 17345 Civic Dr Ste 1331
Brookfield, WI 53045-5070 - Phone
- (262) 462-0216
- NPI assigned
- Sep 29, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 7060-226 | WI | Primary |
Addresses
Primary practice location
17345 Civic Dr Ste 1331
Brookfield, WI 53045-5070
Mailing address
17345 Civic Dr Ste 1331
Brookfield, WI 53045-5070
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7060-226 | WI | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664409600000",
"number": "1154045474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17345 CIVIC DR STE 1331",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530455070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17345 CIVIC DR STE 1331",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530455070",
"telephone_number": "262-462-0216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYSOCKI",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-29",
"last_updated": "2022-09-29",
"certification_date": "2022-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WI",
"license": "7060-226",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.