Jeffrey Allan Kimel, LPC, CSAC, ICS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5797-125 Issued in WI

Practice address

16 N Carroll St
Suite 400
Madison, WI 53703-2716

Phone

(262) 898-2940

NPI assigned

Dec 8, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Madison Behavioral Services, LLC

  • Community/Behavioral Health Agency
  • Montrose, MI
  • NPI 1164808796

  Professional

  NPD Authorized official

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

{
    "created_epoch": "1386460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1255762886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 N CARROLL ST STE 400",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032762",
            "telephone_number": "608-514-1672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 N CARROLL ST",
            "address_2": "SUITE 400",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537032716",
            "telephone_number": "262-898-2940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4810 Northwestern Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "WI",
            "postal_code": "534061504",
            "country_code": "US",
            "telephone_number": "262-637-9984",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMEL",
        "first_name": "JEFFREY",
        "middle_name": "ALLAN",
        "name_prefix": "Mr.",
        "credential": "LPC, CSAC, ICS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-08",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16013-132",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "1996 - 226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5797-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100095265",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theodore Kim, M.D.
• Woo Sung Kim, MD
• Karen K Kimball, PHD
• Stephanie Nicole Wagoner Kimball, D.D.S.
• Jacqueline Kimble, PT
• Brandon James Kimes, MD
• Glenn Kimmel, MD
• Ibuki A Kimura, MD
• Ray Kimura, MD
• Charna Kinard, MD

• Professional Counselor in Madison, WI
• Providers in Madison, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.