Active NPI
Edward C Wipson, MS LPC CSAC
- Mental Health Counselor
- Superior, WI
National Provider Identifier
1306144597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 2342-125
- Practice address
- 1507 Tower Ave
Suite 210
Superior, WI 54880-2532 - Phone
- (715) 392-3331
- NPI assigned
- Mar 11, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2025-132 | WI | |
| Mental Health Counselor | 101YM0800X | 2342-125 | WI | Primary |
Addresses
Primary practice location
1507 Tower Ave
Suite 210
Superior, WI 54880-2532
Mailing address
1507 Tower Ave
Suite 210
Superior, WI 54880-2532
Phone (715) 392-3331
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 |
|---|---|---|---|
| 2025-132 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 2342-125 | WI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299801600000",
"number": "1306144597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1507 TOWER AVE",
"address_2": "SUITE 210",
"city": "SUPERIOR",
"state": "WI",
"postal_code": "548802532",
"telephone_number": "715-392-3331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1507 TOWER AVE",
"address_2": "SUITE 210",
"city": "SUPERIOR",
"state": "WI",
"postal_code": "548802532",
"telephone_number": "715-392-3331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIPSON",
"first_name": "EDWARD",
"middle_name": "C",
"name_prefix": "Mr.",
"credential": "MS LPC CSAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-03-11",
"last_updated": "2011-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "2025-132",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WI",
"license": "2342-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Superior, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.