Carly N Maas, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

10226-125 Issued in WI

Practice address

630 S 36TH Ave
Wausau, WI 54401-3930

Phone

(715) 842-9500

NPI assigned

Feb 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Carly N Krueger Former name

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

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Behavioral Health Clinic LLCGroup PAC ID 8628409885, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Behavioral Health Clinic, LLC

  • Clinical Psychologist
  • Wausau, WI
  • NPI 1831442359

  Addiction (Substance Use Disorder), WI

  Medicare reassignment Care Compare group NPD
• Behavioral Health Clinic, LLC

  • Clinical Psychologist
  • Grafton, WI
  • NPI 1902698533

  Addiction (Substance Use Disorder)

  NPD

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1336733286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S 36TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S 36TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013930",
            "telephone_number": "715-842-9500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2417 Post Rd",
            "address_purpose": "LOCATION",
            "city": "Stevens Point",
            "state": "WI",
            "postal_code": "544816124",
            "country_code": "US",
            "telephone_number": "715-544-6144",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAAS",
        "first_name": "CARLY",
        "middle_name": "N",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-22",
        "last_updated": "2023-03-31",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "19153",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4662",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "10226-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "KRUEGER",
            "middle_name": "N",
            "credential": "LPC-IT, SAC-IT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Skyler C Lynn, PT
• Ezra Lyon, M.D.
• Deborah L. Lyons, MSE, SAC-IT
• Jamie Rogalla Lyons, PA-C
• M.P.T.C.
• Charles Francis Maccarthy, M.D.
• Maureen Macconnell, APNP
• Patrick Mace, OTR
• Maddie Ann Machowski
• Jason D Mack, DO

• All providers in Wausau, WI
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.