NPIMap

Organization Active NPI

Peaceful Pines Healing Practices, LLC

  • Professional Counselor
  • Pine River, WI
National Provider Identifier
1194252304
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5328-125 Issued in WI
Legal business name
PEACEFUL PINES HEALING PRACTICES, LLC
Practice address
W3470 Badger Rd
Pine River, WI 54965-8118
Phone
(920) 229-3929
NPI assigned
May 18, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Anna M Syke, MS ED, LPC
Title
Owner of Practice
Phone
(920) 229-3929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5328-125 WI Primary

Addresses

Primary practice location

W3470 Badger Rd
Pine River, WI 54965-8118

Mailing address

W3470 Badger Rd
Pine River, WI 54965-8118
Phone (920) 229-3929

Other identifiers 1

IdentifierTypeStateIssuer
1861810194OtherWIINDIVIDUAL NPI FOR OWNER OF PRACTICE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1194252304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W3470 BADGER RD",
            "city": "PINE RIVER",
            "state": "WI",
            "postal_code": "549658118",
            "telephone_number": "920-229-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W3470 BADGER RD",
            "city": "PINE RIVER",
            "state": "WI",
            "postal_code": "549658118",
            "telephone_number": "920-229-3929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL PINES HEALING PRACTICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-18",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SYKE",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER OF PRACTICE",
        "authorized_official_telephone_number": "920-229-3929",
        "authorized_official_credential": "MS ED, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5328-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI FOR OWNER OF PRACTICE",
            "identifier": "1861810194",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine River, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.