Isaac Theodore Kabacinski, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10053-123 Issued in WI

Practice address

119 N McCarthy Rd Ste P
Appleton, WI 54913-9112

Phone

(920) 903-1060

Fax

(920) 903-1164

NPI assigned

Jul 6, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

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.

• US 2 Behavioral Health Care Inc

  • Professional Counselor
  • Appleton, WI
  • NPI 1083268635
  Medicare reassignment NPD
• Nicklaus Counseling Center SC

  • Professional Counselor
  • Marinette, WI
  • NPI 1033659271
  NPD (past)
• Peace Counseling & Support Services LLC

  • Mental Health Counselor
  • Marinette, WI
  • NPI 1992633309

  Clinical

  NPD (past)

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1366060469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 N MCCARTHY RD STE P",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139112",
            "telephone_number": "920-903-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 N MCCARTHY RD STE P",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139112",
            "telephone_number": "920-903-1060",
            "fax_number": "920-903-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABACINSKI",
        "first_name": "ISAAC",
        "middle_name": "THEODORE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-06",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "131888-121",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "10053-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100138546",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George M Jumes, DDS
• Jane L Jumes, PA
• Kristine Grace Juntunen, M.D.
• Mindee Juve, PHD
• Alexa Liane Juzenas, PA-C
• Paula Kabat, COTA
• Taylor Kaboord, PHARMD
• Ameer Kabour, MD
• Jenna Marie Kadlec, P.T.
• Sarah Kate Kaeser, RN

• Clinical Social Worker in Appleton, WI
• Providers in Appleton, 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 Dec 12, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.