Individual provider Active NPI

Lydia Zopf

  • Professional Counselor
  • Kenosha, WI
National Provider Identifier
1225663396
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6661-125 Issued in WI
Practice address
2001 Alford Park Dr.
Carthage College
Kenosha, WI 53140
Phone
(262) 551-5710
NPI assigned
Mar 9, 2020
Last updated
Mar 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180008121 IL
Professional Counselor 101YP2500X 6661-125 WI Primary

Addresses

Primary practice location

2001 Alford Park Dr.
Carthage College
Kenosha, WI 53140

Mailing address

2106 26TH St
Kenosha, WI 53140-4907

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
180008121ILMDProfessional Counselor
6661-125WIMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1583712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1225663396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 26TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 ALFORD PARK DR.",
            "address_2": "CARTHAGE COLLEGE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53140",
            "telephone_number": "262-551-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOPF",
        "first_name": "LYDIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-09",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180008121",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6661-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; 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.