Active NPI
Hannah Christine Konetzke, CSAC, LPC-IT
- Counselor
- New London, WI
National Provider Identifier
1245747021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 7481-226
- Practice address
- E7475 Rawhide Rd
New London, WI 54961-9025 - Phone
- (920) 982-6100
- NPI assigned
- Jan 3, 2018
- Last updated
- Sep 30, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 7481-226 | WI | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 16452-132 | WI |
Addresses
Primary practice location
E7475 Rawhide Rd
New London, WI 54961-9025
Mailing address
129 N James St
Kimberly, WI 54136-1838
Phone (920) 277-9678
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7481-226 | WI | MD | Counselor |
| 16452-132 | WI | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Outagamie | Past | Accepting new patients | |
| Rawhide Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Appleton, WI
- NPI 1629138995
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- New London, WI
- NPI 1841334620
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727654400000",
"number": "1245747021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 N JAMES ST",
"city": "KIMBERLY",
"state": "WI",
"postal_code": "541361838",
"telephone_number": "920-277-9678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "E7475 RAWHIDE RD",
"city": "NEW LONDON",
"state": "WI",
"postal_code": "549619025",
"telephone_number": "920-982-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONETZKE",
"first_name": "HANNAH",
"middle_name": "CHRISTINE",
"credential": "CSAC, LPC-IT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-03",
"last_updated": "2024-09-30",
"certification_date": "2024-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WI",
"license": "7481-226",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "16452-132",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New London, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.