Stephanie Lynn White Eagle, MFT,CSAC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1258-124 Issued in WI

Practice address

S2845 White Eagle Rd
Baraboo, WI 53913-9064

Phone

(608) 355-1240

Fax

(608) 356-7152

NPI assigned

Sep 4, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Marriage and Family Therapist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Community Service Associates, SCGroup PAC ID 8426948746, 34 clinicians

Ho Chunk NationGroup PAC ID 5496709867, shared by 2 NPIs, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Community Service Associates, SC

  dba Pauquette Center for Psychological Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portage, WI
  • NPI 1780610923
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1252022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1184957334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S2845 WHITE EAGLE RD",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539139064",
            "telephone_number": "608-355-1240",
            "fax_number": "608-356-7152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S2845 WHITE EAGLE RD",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539139064",
            "telephone_number": "608-355-1240",
            "fax_number": "608-356-7152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE EAGLE",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "MFT,CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-04",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "11480-132",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "1258-124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184957334",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wenzel Chiropractic, S.C.
• William Don Wenzel, D.C.
• Niki Wezensky, MSW, APSW
• Sarah Jane Wheeler, MA
• Joseph White Eagle Sr., SAC
• Keri E Wilcox, BSW
• Patricia A E Wilson, RD CD
• Julie M Witmer
• Meghan Elizabeth Witt, DC
• Steven M Witters, D.C.

• Marriage & Family Therapist in Baraboo, WI
• Providers in Baraboo, WI by specialty
• Marriage & Family Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.