Kyle Kershek, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

8462 Issued in WI

Practice address

3150 Gershwin Dr
Green Bay, WI 54311-4328

Phone

(920) 391-4700

Fax

(920) 391-4731

NPI assigned

Feb 15, 2024

Last updated

Feb 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Amanda Donath Psychological Services S C

  dba Peace Of Mind Wellness

  • Professional Counselor
  • Oconomowoc, WI
  • NPI 1356961775
  Medicare reassignment NPD

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

{
    "created_epoch": "1707955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1396500724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 GERSHWIN DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114328",
            "telephone_number": "920-391-4700",
            "fax_number": "920-391-4731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 GERSHWIN DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114328",
            "telephone_number": "920-391-4700",
            "fax_number": "920-391-4731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSHEK",
        "first_name": "KYLE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helen Louise Keough, R.N.
• Stephanie Keranen, COTA
• Jennifer Kerelko, BCBA
• Tricia Ann Kerker, LPC
• Aliece Ann Kerscher
• Cynthia Vida Ketter, PHYSICAL THERAPIST
• Rebecca L Ketterhagen, PA
• Masin Kettner
• Keystone Psychology LLC
• Sany T Khabbaz, MD

• Professional Counselor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.