NPIMap

Individual provider Active NPI

Michelle Wisneski

  • Mental Health Counselor
  • Appleton, WI
National Provider Identifier
1285923870
Registry record updated Apr 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
127-3605381 Issued in WI
Practice address
821 E 1St Ave
Suite 5
Appleton, WI 54911-1586
Phone
(920) 257-4601
NPI assigned
Apr 4, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 127-3605381 WI Primary

Addresses

Primary practice location

821 E 1St Ave
Suite 5
Appleton, WI 54911-1586

Mailing address

1068 Sandpoint RDG
Neenah, WI 54956-5639
Phone (920) 574-5946

Other names 1

  • Michelle Klassen Former name

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

LicenseStateTypeSpecialty
127-3605381WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Connections, LLC Past Accepting new patients

Organizations & group practices 1

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": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1285923870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 SANDPOINT RDG",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549565639",
            "telephone_number": "920-574-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 E 1ST AVE",
            "address_2": "SUITE 5",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111586",
            "telephone_number": "920-257-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNESKI",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "127-3605381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "KLASSEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; 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.