Kim Hannan, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4450-125 Issued in WI

Practice address

405 E Forest St
Oconomowoc, WI 53066-3707

Phone

(262) 269-1569

NPI assigned

Oct 16, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1287187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1437469061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N8238 WOODY LN",
            "city": "IXONIA",
            "state": "WI",
            "postal_code": "530369551",
            "telephone_number": "262-719-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 E FOREST ST",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530663707",
            "telephone_number": "262-269-1569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAN",
        "first_name": "KIM",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-16",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "259-226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4450-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Hackbarth, LPC
• Bethany Hafenstein-Riege
• Samuel Hall, MD
• Jerry Lee Halverson, MD
• Elizabeth A Hamlin, MD
• Richard Morris Hansen, MD
• Bridgette Marie Hanson, RN
• James Joseph Harper, M.D.
• Jamie Healy, LMT
• Hearing Center, Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2023; 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.