Jackie K. Richter, CSAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5179 Issued in WI

Practice address

212 11TH St S
La Crosse, WI 54601-4116

Phone

(608) 392-9555

NPI assigned

May 30, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Jackie K. Richter-Moser Former name

Electronic endpoints 1

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mayo Clinic Health System-Southwest Wisconsin Region IncGroup PAC ID 0345152443, 539 clinicians

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 and National Provider Directory roles.

• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  • Multi-Specialty Clinic/Center
  • La Crosse, WI
  • NPI 1629056049
  Medicare reassignment Care Compare group NPD
• Mayo Clinic Health System-Southwest Wisconsin Region, Inc.

  • Multi-Specialty Clinic/Center
  • La Crosse, WI
  • NPI 1942980917
  NPD

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1447511183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1510",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547021510",
            "telephone_number": "715-838-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 11TH ST S",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014116",
            "telephone_number": "608-392-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHTER",
        "first_name": "JACKIE",
        "middle_name": "K.",
        "credential": "CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15750",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5179",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "5179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jrichter27119@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "212 11th St S",
            "city": "LA Crosse",
            "state": "WI",
            "country_code": "US",
            "postal_code": "546014116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "RICHTER-MOSER",
            "middle_name": "K.",
            "credential": "SAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexander S Rich
• Melissa Richards, BSW
• David Thomas Richardson, D.D.S.
• Mariah L Richardson
• Rita A Richmond, APNP
• Alexandra Jo Rickaby
• Ashley Rickaway
• Zachary C Rickaway, PT
• Steven James Rickett, DO
• Connie Anne Rickman

• Mental Health Counselor in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Mental Health Counselor in Wisconsin

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