Individual provider Active NPI

Grady O'Neill, MA

  • Professional Counselor
  • Hurley, WI
National Provider Identifier
1245695899
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
12076-125 Issued in WI
Practice address
115 5TH Ave N
Hurley, WI 54534-1208
Phone
(715) 329-1288
NPI assigned
Dec 28, 2015
Last updated
Sep 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Art Therapist 221700000X 217-36 WI
Professional Counselor 101YP2500X 12076-125 WI Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2-01483 MI

Addresses

Primary practice location

115 5TH Ave N
Hurley, WI 54534-1208

Mailing address

115 5TH Ave N
Hurley, WI 54534-1208
Phone (715) 329-1288

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
I20251209004446 WI Practitioner - Mental Health Counselor 2062787914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7665 US Hwy 2
Iron River, WI 54847-4690
Phone (715) 372-5001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2-01483MIMDAddiction (Substance Use Disorder) Counselor
12076-125WIMDProfessional Counselor
217-36WIMDArt Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Lakes Community Health Center, Inc CurrentSince Oct 3, 2025 Accepting new patients
The Lakes Community Health Center, Inc CurrentSince Oct 3, 2025 Accepting new patients
The Lakes Community Health Center, Inc CurrentSince Sep 28, 2025 Accepting new patients

Locations

300 Main St W
Ashland, WI 54806
Phone (715) 685-2200

115 5th Ave N
Hurley, WI 54534
Phone (715) 329-1288

7665 US Highway 2
Iron River, WI 54847
Phone (715) 364-8565

Organizations & group practices 3

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": "1451260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1245695899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 5TH AVE N",
            "city": "HURLEY",
            "state": "WI",
            "postal_code": "545341208",
            "telephone_number": "715-329-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 5TH AVE N",
            "city": "HURLEY",
            "state": "WI",
            "postal_code": "545341208",
            "telephone_number": "715-329-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "GRADY",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-28",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "WI",
            "license": "217-36",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "12076-125",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "2-01483",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurley, WI

Sources for this page

Verify at the official NPI Registry.