Kathryn Lynn Mazack

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5923-125 Issued in WI

Practice address

700 Ray O Vac Dr Ste 220
Madison, WI 53711-2476

Phone

(608) 276-9191

Fax

(608) 276-9144

NPI assigned

Oct 5, 2021

Sex

Female

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychology Associates LLPGroup PAC ID 2062434921, 4 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.

• Psychology Associates LLP

  • Professional Counselor
  • Madison, WI
  • NPI 1902952203

  Professional, WI

  Medicare reassignment Care Compare group NPD
• Peter C. Jackson, PSYD Consulting, SC

  • Clinical Psychologist
  • Madison, WI
  • NPI 1881058675
  NPD

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1194497313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 TROY DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537041575",
            "telephone_number": "608-445-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 RAY O VAC DR STE 220",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112476",
            "telephone_number": "608-276-9191",
            "fax_number": "608-276-9144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZACK",
        "first_name": "KATHRYN",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5923-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Rose Mayhew, MS, APNP
• Rose Mayo, APNP
• Sierra Mayorga, RN, DNP, APRN
• Rachel Mays, PHARMD
• Gabino Manuel Mariano Maza Rodas, M.D.
• Haggi Mazeh, MD
• MB Psychotherapy LLC
• Olivier Mba, CRNA
• Rheiner Nnenna Vivian Mbaezue
• Marcia MC Arron, BA

• All providers in Madison, WI
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.