Individual provider Active NPI

Nicole Lynn McKeown, MS, LPC

  • Mental Health Counselor
  • Beloit, WI
National Provider Identifier
1356792964
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6989-125 Issued in WI
Practice address
Beloit Health System Inc Counseling Care Center
1969 W Hart Road
Beloit, WI 53511-2230
Phone
(608) 364-5686
Fax
(608) 635-5756
NPI assigned
Jun 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1113-226 WI
Mental Health Counselor 101YM0800X 6989-125 WI Primary

Addresses

Primary practice location

Beloit Health System Inc Counseling Care Center
1969 W Hart Road
Beloit, WI 53511-2230

Mailing address

Beloit Health System Inc Counseling Care Center
1969 W Hart Road
Beloit, WI 53511-2230
Phone (608) 364-5686

Other identifiers 2

IdentifierTypeStateIssuer
100057422MedicaidWI
1113-226MedicaidWI

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
I20240930000706 WI Practitioner - Mental Health Counselor 2163860222 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1113-226WIMDMental Health Counselor
6989-125WIMDMental Health Counselor
2013WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Beloit Health System, Inc CurrentSince Jul 13, 2024 Accepting new patients
Beloit Health System Inc Current Accepting new patients
Beloit Health System, Inc CurrentSince Jul 13, 2024 Accepting new patients
Beloit Health System, Inc Past Accepting new patients
Beloit Health System Inc Past Accepting new patients

Locations

1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

1033 Woodward Ave
Beloit, WI 53511
Phone (608) 361-4300

1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510

Organizations & group practices 5

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": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1356792964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BELOIT HEALTH SYSTEM INC COUNSELING CARE CENTER",
            "address_2": "1969 W HART ROAD",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535112230",
            "telephone_number": "608-364-5686",
            "fax_number": "608-635-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BELOIT HEALTH SYSTEM INC COUNSELING CARE CENTER",
            "address_2": "1969 W HART ROAD",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535112230",
            "telephone_number": "608-364-5686",
            "fax_number": "608-635-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEOWN",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2025-07-24",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "1113-226",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "6989-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100057422",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1113-226",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

Verify at the official NPI Registry.