Kevin Wahl

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6806-125 Issued in WI

Practice address

1021 E Fitzsimmons Rd
Oak Creek, WI 53154-5205

Phone

(414) 975-2843

NPI assigned

Oct 15, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cornerstone Counseling Services IncGroup PAC ID 1456256023, 338 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.kevinwahl@149809.advancedmd-direct.com

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.

• Cornerstone Counseling Services, Inc

  dba LifeStance Health

  • Mental Health Counselor
  • Brookfield, WI
  • NPI 1033127246
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1174994164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 E FITZSIMMONS RD",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531545205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 E FITZSIMMONS RD",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531545205",
            "telephone_number": "414-975-2843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHL",
        "first_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-15",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6806-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Visiting Medical Doctors
• Amanda Volbrecht, LPC, SAC-IT
• Shannon Marie Vondra, MD
• Caitlin Vosberg, APNP
• Nhan Thanh Vu, PHARMD
• Jordynn Lee Wales, DPT
• Walgreen Co (Walgreens #04887)
• Jami L Wallace
• Amanda Wandall
• Desiree J Ware, LPC-IT

• Professional Counselor in Oak Creek, WI
• Providers in Oak Creek, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.