Kristin Joy Eitland

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3904-226 Issued in WI

Practice address

2201 Jack Breault Dr
Hudson, WI 54016-4547

Phone

(715) 629-8300

NPI assigned

Jul 18, 2018

Sex

Female

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

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 and National Provider Directory roles.

• Cornerstone Counseling Services, Inc

  • Mental Health Counselor
  • Brookfield, WI
  • NPI 1033127246
  NPD
• Refresh Midwest Operations, SC

  • Psychologist
  • Hudson, WI
  • NPI 1932625357
  NPD (past)

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1417433855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 COUNTY ROAD NN",
            "city": "WILSON",
            "state": "WI",
            "postal_code": "540273810",
            "telephone_number": "817-504-3812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 JACK BREAULT DR",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540164547",
            "telephone_number": "715-629-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EITLAND",
        "first_name": "KRISTIN",
        "middle_name": "JOY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3904-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista Jo Dorgan, MA, LMFT
• Michele Anne Drevnick, M.S., F-AAA
• Riley Drinkwine
• Jacqueline S. Dsouza, M.D.
• Brenda Kristy Eckerman, PT
• Emma Ekstrand, COTA
• Ahmed Abdalla Elhindi, DO
• Jennifer Elsesser, LPC
• Jon H. Engelking, M.D.
• Sarah Engen, DCM, BCTMB

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.