NPIMap

Organization Active NPI

Life Point Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Plymouth, WI
National Provider Identifier
1407097371
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
3459-125 Issued in WI
Legal business name
LIFE POINT COUNSELING, LLC
Practice address
2209 Eastern Ave
Plymouth, WI 53073-4281
Phone
(920) 892-7606
Fax
(920) 449-4247
NPI assigned
Mar 23, 2009
Last updated
Apr 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Authorized official

Name
Molly Ellen Steuerwald
Title
Office Manager
Phone
(920) 892-7606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 3459-125 WI Primary

Addresses

Primary practice location

2209 Eastern Ave
Plymouth, WI 53073-4281

Mailing address

2209 Eastern Ave
Plymouth, WI 53073-4281
Phone (920) 892-7606

Other identifiers 1

IdentifierTypeStateIssuer
100061500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210518000621 WI Part B Supplier - Clinic/Group Practice 1254740525 Receives reassigned benefits from 9 practitioners
Practice locations: Plymouth, WI

National Provider Directory

National Provider Directory

Locations

927 Center Ave
Ste 4
Oostburg, WI 53070
Phone (920) 892-7606

2209 Eastern Ave
Plymouth, WI 53073
Phone (920) 449-4247

411 E Mill St
Ste 104
Plymouth, WI 53073

1000 N Wisconsin St
Stop 9
Port Washington, WI 53074

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682553600000",
    "number": "1407097371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 EASTERN AVE",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530734281",
            "telephone_number": "920-892-7606",
            "fax_number": "920-449-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 EASTERN AVE",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530734281",
            "telephone_number": "920-892-7606",
            "fax_number": "920-449-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE POINT COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-23",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A",
        "authorized_official_last_name": "STEUERWALD",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "920-892-7606"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WI",
            "license": "3459-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100061500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.