Individual provider Active NPI

Kiersten Wenthold, LPC

  • Professional Counselor
  • Beloit, WI
National Provider Identifier
1255998605
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
3005 S Riverside Dr
Beloit, WI 53511-1500
Phone
(608) 299-7669
NPI assigned
May 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

3005 S Riverside Dr
Beloit, WI 53511-1500

Mailing address

3005 S Riverside Dr
Beloit, WI 53511-1500
Phone (608) 299-7669

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
I20240828003706 WI Practitioner - Mental Health Counselor 7810337631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enlightened Ways Therapy, LLCGroup PAC ID 9830560747, 3 clinicians

Practice addresses (Care Compare)

3005 S Riverside Dr
Suite 102
Beloit, WI 53511-1500
Phone (608) 299-7669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Enlightened Ways Therapy, LLC Professional CurrentSince Aug 1, 2024 Accepting new patients
West Grove Clinic, SC PastSince Oct 30, 2024 Accepting new patients

Locations

3005 S Riverside Dr
Ste 102
Beloit, WI 53511
Phone (608) 299-7669

1001 W Glen Oaks Ln
Ste 105
Mequon, WI 53092
Phone (414) 258-8314

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.

NPI Registry JSON

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1255998605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 S RIVERSIDE DR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111500",
            "telephone_number": "608-299-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 S RIVERSIDE DR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111500",
            "telephone_number": "608-299-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTHOLD",
        "first_name": "KIERSTEN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

Verify at the official NPI Registry.