Individual provider Active NPI

Kimberly A. Hlavka, LPC

  • Mental Health Counselor
  • Neenah, WI
National Provider Identifier
1396943130
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3391-125 Issued in WI
Practice address
1509 S Commercial St
Neenah, WI 54956-6152
Phone
(920) 722-8150
Fax
(920) 722-0142
NPI assigned
Jul 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3391-125 WI Primary

Addresses

Primary practice location

1509 S Commercial St
Neenah, WI 54956-6152

Mailing address

1509 S Commercial St
Neenah, WI 54956-6152
Phone (920) 722-8150

Other identifiers 1

IdentifierTypeStateIssuer
40993000MedicaidWI

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
I20250324000966 WI Practitioner - Mental Health Counselor 1153795463 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3391-125WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Reach Counseling Services, Inc. Mental Health CurrentSince Dec 15, 2024 Accepting new patients
Integrity Counseling, LLC Past Accepting new patients

Locations

1509 S Commercial St
Neenah, WI 54956
Phone (920) 470-4503

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1396943130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 S COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549566152",
            "telephone_number": "920-722-8150",
            "fax_number": "920-722-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 S COMMERCIAL ST",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549566152",
            "telephone_number": "920-722-8150",
            "fax_number": "920-722-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HLAVKA",
        "first_name": "KIMBERLY",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "3391-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40993000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.