Individual provider Active NPI

Mary Kay Haupt, LPC, SAC

  • Professional Counselor
  • La Crosse, WI
National Provider Identifier
1164179503
Registry record updated Mar 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6553-125 Issued in WI
Practice address
2920 East Ave S
La Crosse, WI 54601-8231
Phone
(608) 790-9481
NPI assigned
Mar 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 16174-131 WI
Professional Counselor 101YP2500X 6553-125 WI Primary

Addresses

Primary practice location

2920 East Ave S
La Crosse, WI 54601-8231

Mailing address

W6171 Valley PL
Holmen, WI 54636-9481
Phone (608) 386-2981

Other practice location 1

W6171 Valley Pl
Holmen, WI 54636-9481
Phone (608) 386-2981

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
16174-131WIMDAddiction (Substance Use Disorder) Counselor
6553-125WIMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1646524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646524800000",
    "number": "1164179503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W6171 VALLEY PL",
            "city": "HOLMEN",
            "state": "WI",
            "postal_code": "546369481",
            "telephone_number": "608-386-2981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 EAST AVE S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546018231",
            "telephone_number": "608-790-9481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W6171 Valley Pl",
            "address_purpose": "LOCATION",
            "city": "Holmen",
            "state": "WI",
            "postal_code": "546369481",
            "country_code": "US",
            "telephone_number": "608-386-2981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAUPT",
        "first_name": "MARY",
        "middle_name": "KAY",
        "credential": "LPC, SAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-06",
        "last_updated": "2022-03-06",
        "certification_date": "2022-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16174-131",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6553-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.

Verify at the official NPI Registry.