Individual provider Active NPI

Kimberly Ann Teske, LCSW

  • Mental Health Counselor
  • Appleton, WI
National Provider Identifier
1154517522
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
401 S Elm St
Appleton, WI 54911-5900
Phone
(920) 832-5270
NPI assigned
Sep 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

401 S Elm St
Appleton, WI 54911-5900

Mailing address

401 S Elm St
Appleton, WI 54911-5900
Phone (920) 832-5270

Other names 1

  • Miss Kimberly Ann Baines Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190528001938 WI Practitioner - Clinical Social Worker 7719220169 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Outagamie CurrentSince Mar 31, 2019 Accepting new patients

Locations

320 S Walnut St
Appleton, WI 54911
Phone (920) 832-1624

401 S Elm St
Appleton, WI 54911
Phone (414) 832-5270

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1154517522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S ELM ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115900",
            "telephone_number": "920-832-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S ELM ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115900",
            "telephone_number": "920-832-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESKE",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-19",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "BAINES",
            "middle_name": "ANN",
            "prefix": "MISS",
            "credential": "B.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.