Kyle J Prorok, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5504-125 Issued in WI

Practice address

400 Congress Ave
Viroqua, WI 54665-1309

Phone

(608) 632-9176

Fax

(608) 637-8000

NPI assigned

Aug 20, 2013

Sex

Male

Sole proprietor

Yes

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

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.

• Thrive Counseling

  • Community/Behavioral Health Agency
  • Viroqua, WI
  • NPI 1366983959
  NPD (past) Authorized official

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1376976738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E10671 GORE HOLLOW RD",
            "city": "VIOLA",
            "state": "WI",
            "postal_code": "546648054",
            "telephone_number": "608-632-9176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CONGRESS AVE",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546651309",
            "telephone_number": "608-632-9176",
            "fax_number": "608-637-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROROK",
        "first_name": "KYLE",
        "middle_name": "J",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-20",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "1607-226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5504-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376976738",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Craig Aaron Pierce, PA
• Laura A Poe, RD, LD
• Alexa Pomerleau
• John C Porter, DO
• Deborah L Prior, M.D.
• Psychiatric Associates Counseling Center LLC
• Tauqeer Qazi, MD
• Quality of Life Chiropractic
• Jon D Radcliffe, DO
• Ann Elizabeth Ralles, DDS

• Professional Counselor in Viroqua, WI
• Providers in Viroqua, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.