Kristin C Kouba, MSW, APSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

131558 Issued in WI

Practice address

141 Siegler St
Green Bay, WI 54303-2635

Phone

(920) 433-3372

Fax

(920) 432-5966

NPI assigned

Apr 28, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Family Services of Northeast Wi

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1194842880
  NPD (past)
• Family Services of Northeast Wisconsin Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Menasha, WI
  • NPI 1275525925
  NPD (past)
• Family Services of Northeast Wisconsin Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1467453167
  NPD (past)

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1346861556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22308",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052308",
            "telephone_number": "920-436-6800",
            "fax_number": "920-432-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 SIEGLER ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032635",
            "telephone_number": "920-433-3372",
            "fax_number": "920-432-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUBA",
        "first_name": "KRISTIN",
        "middle_name": "C",
        "credential": "MSW, APSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-28",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "131558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346861556",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel G Koster, MD SC
• Kathleen Apnp Koszarek, MSN
• John Joseph Koszuta, M.D.
• Lauren Koth
• Nicole Kotila, RPH
• Eugeni T Kouzov, M.D.
• Kathleen Mary Kowalke, LPC, CTRS
• Julianne Kowalski
• Jane Elizabeth Kozicki, RN
• Jacob A Kozisek, OD

• Clinical Social Worker in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.