Judith Ann Kistner, M.S.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2078125 Issued in WI

Practice address

550 N Dewey St
Eau Claire, WI 54703-3218

Phone

(715) 834-6681

Fax

(715) 834-9954

NPI assigned

Apr 16, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208304000000",
    "number": "1174797633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 N DEWEY ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547033218",
            "telephone_number": "715-834-6681",
            "fax_number": "715-834-9954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 N DEWEY ST",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547033218",
            "telephone_number": "715-834-6681",
            "fax_number": "715-834-9954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTNER",
        "first_name": "JUDITH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2008-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "2078125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40945000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; 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.