Active NPI
Kirsten Elise Seline, LPC-IT, SAC-IT
- Counselor
- West Bend, WI
National Provider Identifier
1255083192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 5074
- Practice address
- 724 Elm St
West Bend, WI 53095-3205 - Phone
- (262) 353-9701
- NPI assigned
- Jan 21, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 5074 | WI | Primary |
Addresses
Primary practice location
724 Elm St
West Bend, WI 53095-3205
Mailing address
6233 39TH Ave
Kenosha, WI 53142-7015
Phone (262) 654-1004
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Services Group, Inc. | Past | Accepting new patients | |
| Catalpa Health | 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 and National Provider Directory roles.
-
- Adolescent and Children Mental Health Clinic/Center
- Appleton, WI
- NPI 1770967762
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Kenosha, WI
- NPI 1619024262
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642723200000",
"number": "1255083192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6233 39TH AVE",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531427015",
"telephone_number": "262-654-1004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "724 ELM ST",
"city": "WEST BEND",
"state": "WI",
"postal_code": "530953205",
"telephone_number": "262-353-9701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SELINE",
"first_name": "KIRSTEN",
"middle_name": "ELISE",
"credential": "LPC-IT, SAC-IT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-21",
"last_updated": "2022-01-21",
"certification_date": "2022-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WI",
"license": "5074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Bend, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.