Kimberly Haas, SAC-IT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

17415-130 Issued in WI

Practice address

158 S Anderson St
Suite 3
Rhinelander, WI 54501-3447

Phone

(715) 369-7300

Fax

(715) 369-7301

NPI assigned

Mar 19, 2015

Last updated

Mar 19, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Effinger Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 15, 2024 through May 15, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426723200000",
    "number": "1205220001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-423-4100",
            "fax_number": "414-423-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 S ANDERSON ST",
            "address_2": "SUITE 3",
            "city": "RHINELANDER",
            "state": "WI",
            "postal_code": "545013447",
            "telephone_number": "715-369-7300",
            "fax_number": "715-369-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAS",
        "first_name": "KIMBERLY",
        "credential": "SAC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-19",
        "last_updated": "2015-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17415-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "EFFINGER",
            "credential": "SAC-IT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Grill, FNP
• Terry R Gromer, PTA
• Heidi Grosskopf, AU.D.
• Erin Gustafson, MA CCC-SLP
• William G Gustafson, MD
• Amber Marie Hagen, LICENSED PRACTICAL N
• Karen Hagen, NP
• Madeline Jeanne Hallisy, DPT
• Heidi L Hammer, PA-C
• Brian Scott Hansen, D.C.

• Addiction (Substance Use Disorder) Counselor in Rhinelander, WI
• Providers in Rhinelander, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.