Individual provider Active NPI

Kimberly J Lohman, LPC CSAC

  • Professional Counselor
  • Madison, WI
National Provider Identifier
1245661040
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6019-125 Issued in WI
Practice address
621 N Sherman Ave Ste B17
Madison, WI 53704-4445
Phone
(608) 893-1050
Fax
(608) 893-1503
NPI assigned
Dec 3, 2013
Last updated
Mar 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15896-132 WI
Professional Counselor 101YP2500X 6019-125 WI Primary

Addresses

Primary practice location

621 N Sherman Ave Ste B17
Madison, WI 53704-4445

Mailing address

2801 International LN Ste 205
Madison, WI 53704-3152
Phone (608) 616-4589

Other practice location 1

2801 International Ln Ste 205
Madison, WI 53704-3152
Phone (608) 616-4589

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
I20240626003262 WI Practitioner - Mental Health Counselor 7810431228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

621 N Sherman Ave
Suite B17
Madison, WI 53704-4445
Phone (608) 893-1053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15896-132WIMDAddiction (Substance Use Disorder) Counselor
6019-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Recovery Addiction (Substance Use Disorder) CurrentSince May 12, 2024 Accepting new patients

Locations

621 N Sherman Ave
Ste B17
Madison, WI 53704
Phone (608) 893-1050

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1245661040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 INTERNATIONAL LN STE 205",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537043152",
            "telephone_number": "608-616-4589",
            "fax_number": "608-241-4286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 N SHERMAN AVE STE B17",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044445",
            "telephone_number": "608-893-1050",
            "fax_number": "608-893-1503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2801 International Ln Ste 205",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537043152",
            "country_code": "US",
            "telephone_number": "608-616-4589",
            "fax_number": "608-250-2516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOHMAN",
        "first_name": "KIMBERLY",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LPC   CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-03",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15896-132",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6019-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.