Individual provider Active NPI

Janelle Kathleen Hafermann, LPC, CSAC, ICS

  • Professional Counselor
  • Wisconsin Rapids, WI
National Provider Identifier
1174952352
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
10484-125 Issued in WI
Practice address
820 Two Mile Ave
Wisconsin Rapids, WI 54494-6661
Phone
(715) 421-1107
Fax
(715) 421-1108
NPI assigned
Nov 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 10484-125 WI Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15834-132 WI
Mental Health Counselor 101YM0800X 10484-125 WI

Addresses

Primary practice location

820 Two Mile Ave
Wisconsin Rapids, WI 54494-6661

Mailing address

820 Two Mile Ave
Wisconsin Rapids, WI 54494-6661
Phone (715) 421-1107

Other practice location 1

7013 100th St S
Wisconsin Rapids, WI 54494-8950
Phone (715) 697-0071

Other identifiers 1

IdentifierTypeStateIssuer
100086570MedicaidWI

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
I20240131003063 WI Practitioner - Mental Health Counselor 6305299850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

320 W Grand Ave
Suite 204
Wisconsin Rapids, WI 54495-2781
Phone (715) 421-1107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15834-132WIMDAddiction (Substance Use Disorder) Counselor
10484-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hafermann Counseling Collaborative, LLC Addiction (Substance Use Disorder) CurrentSince Jan 1, 2024 Accepting new patients
Edmundson Counseling Addiction (Substance Use Disorder) PastSince Dec 1, 2021 Accepting new patients

Locations

820 Two Mile Ave
Wisconsin Rapids, WI 54494
Phone (715) 421-1107

320 W Grand Ave
Ste 204
Wisconsin Rapids, WI 54495
Phone (715) 421-1107

Organizations & group practices 2

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": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1174952352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 TWO MILE AVE",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544946661",
            "telephone_number": "715-421-1107",
            "fax_number": "715-421-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 TWO MILE AVE",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544946661",
            "telephone_number": "715-421-1107",
            "fax_number": "715-421-1108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7013 100th St S",
            "address_purpose": "LOCATION",
            "city": "Wisconsin Rapids",
            "state": "WI",
            "postal_code": "544948950",
            "country_code": "US",
            "telephone_number": "715-697-0071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAFERMANN",
        "first_name": "JANELLE",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "LPC, CSAC, ICS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "10484-125",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15834-132",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "10484-125",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100086570",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wisconsin Rapids, WI

Sources for this page

Verify at the official NPI Registry.