Individual provider Active NPI

Kathleen Muir, MT-BC, SAC-IT

  • Addiction (Substance Use Disorder) Counselor
  • Waukesha, WI
National Provider Identifier
1215751664
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
20558-130 Issued in WI
Practice address
N19W24101 Riverwood Dr
Waukesha, WI 53188-1109
Phone
(262) 444-0601
NPI assigned
Nov 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Music TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225A00000X 13256 NC
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 20558-130 WI Primary

Addresses

Primary practice location

N19W24101 Riverwood Dr
Waukesha, WI 53188-1109

Mailing address

3276 N 50TH St
Milwaukee, WI 53216-3212
Phone (843) 810-0366

Other names 1

  • Kathleen Long Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20558-130WIMDAddiction (Substance Use Disorder) Counselor
13256NCMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1731369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1215751664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3276 N 50TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532163212",
            "telephone_number": "843-810-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N19W24101 RIVERWOOD DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881109",
            "telephone_number": "262-444-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUIR",
        "first_name": "KATHLEEN",
        "credential": "MT-BC, SAC-IT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-12",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Music Therapist",
            "state": "NC",
            "license": "13256",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "20558-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "LONG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.