Individual provider Active NPI

Carissa Alt-Frankard, M.A., L.P.C

  • Professional Counselor
  • West Bend, WI
National Provider Identifier
1386022572
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5649-125 Issued in WI
Practice address
111 E Washington St
West Bend, WI 53095-2571
Phone
(262) 338-2717
NPI assigned
May 8, 2015
Last updated
Sep 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5649-125 WI Primary

Addresses

Primary practice location

111 E Washington St
West Bend, WI 53095-2571

Mailing address

111 E Washington St
West Bend, WI 53095-2571
Phone (262) 338-2717

Other practice location 1

38 Sell Dr
Hartford, WI 53027-2601
Phone (262) 673-0301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
5649-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Clinical Services Inc CurrentSince Sep 6, 2020 Accepting new patients
Kettle Moraine Counseling LLC PastSince Jan 19, 2020 Accepting new patients

Locations

111 E Washington St
West Bend, WI 53095
Phone (262) 338-2717

400 W River Dr
West Bend, WI 53090
Phone (262) 334-4340

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1386022572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E WASHINGTON ST",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530952571",
            "telephone_number": "262-338-2717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E WASHINGTON ST",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530952571",
            "telephone_number": "262-338-2717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "38 Sell Dr",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "WI",
            "postal_code": "530272601",
            "country_code": "US",
            "telephone_number": "262-673-0301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALT-FRANKARD",
        "first_name": "CARISSA",
        "credential": "M.A., L.P.C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-08",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5649-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.