Individual provider Active NPI

Amy Lynn Henning, LPC

  • Professional Counselor
  • Appleton, WI
National Provider Identifier
1336224922
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3520-125 Issued in WI
Practice address
17 Park PL Ste 200
Appleton, WI 54914-8232
Phone
(920) 212-1456
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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 3520-125 WI Primary

Addresses

Primary practice location

17 Park PL Ste 200
Appleton, WI 54914-8232

Mailing address

1810 Appleton Road
Menasha, WI 54952
Phone (920) 739-4226

Other identifiers 1

IdentifierTypeStateIssuer
40991200MedicaidWI

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
I20250827003767 WI Practitioner - Mental Health Counselor 3779084207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Wisconsin Wellness MH LLCGroup PAC ID 7719487420, 2 clinicians

Practice addresses (Care Compare)

5643 W Waterford LN
Grand Chute, WI 54913-8438
Phone (920) 404-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401007702MIMDCounselor
3520125WIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wisconsin Wellness MH, LLC CurrentSince Jul 15, 2025 Accepting new patients
Family Services of Northeast Wisconsin Inc Past Accepting new patients
Family Services of Northeast Wisconsin Inc Past Accepting new patients

Locations

5643 W Waterford Ln
Grand Chute, WI 54913
Phone (920) 404-2100

Organizations & group practices 3

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": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1336224922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 APPLETON ROAD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "54952",
            "telephone_number": "920-739-4226",
            "fax_number": "920-739-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 PARK PL STE 200",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549148232",
            "telephone_number": "920-212-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNING",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3520-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40991200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.