Individual provider Active NPI

Kay Elizabeth Lisick, MSW, CSAC, ICS

  • Clinical Social Worker
  • La Crosse, WI
National Provider Identifier
1235469339
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8422-123 Issued in WI
Practice address
201 Main St Ste 500
La Crosse, WI 54601-0716
Phone
(608) 668-4005
NPI assigned
Jan 12, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15379-132 WI
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 8422-123 WI
Clinical Social Worker 1041C0700X 8422-123 WI Primary

Addresses

Primary practice location

201 Main St Ste 500
La Crosse, WI 54601-0716

Mailing address

3152 28TH St S
La Crosse, WI 54601-7612
Phone (608) 780-8342

Other identifiers 1

IdentifierTypeStateIssuer
100007373MedicaidWI

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250710002893 WI Practitioner - Clinical Social Worker 0143734079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nystrom and Associates Counseling Wi SCGroup PAC ID 1052729464, 108 clinicians

Practice addresses (Care Compare)

201 Main St
Suite 500
La Crosse, WI 54601-0716
Phone (608) 668-4005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
15379-132WIMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates Counseling Wi., S.C. Multi-Specialty CurrentSince Jul 7, 2025 Accepting new patients
Nystrom & Associates Counseling Wi., S.C. Multi-Specialty CurrentSince Jul 7, 2025 Accepting new patients

Locations

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

201 Main St
Ste 500
La Crosse, WI 54601
Phone (608) 668-4005

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1235469339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3152 28TH ST S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546017612",
            "telephone_number": "608-780-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MAIN ST STE 500",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546010716",
            "telephone_number": "608-668-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISICK",
        "first_name": "KAY",
        "middle_name": "ELIZABETH",
        "credential": "MSW, CSAC, ICS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-12",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15379-132",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "8422-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8422-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100007373",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

Verify at the official NPI Registry.