Sandra Leann Ahlquist, MS
Individual provider Active NPI Professional Counselor · Mauston, WI
NPI 1457098592 · NPPES record last updated Jan 22, 2026
Key facts
- NPI
- 1457098592
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 12236-125 (WI)
- Practice address
- 124 Grayside Ave
Mauston, WI 53948-1913 - Phone
- (608) 847-7575
- NPI assigned
- May 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Pine Valley Integrated Services LLC
Practice addresses (Care Compare)
124 Grayside Ave
Mauston, WI 53948-1913
Phone (608) 847-7575
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260202001844 | WI | Practitioner - Mental Health Counselor | 8921586835 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12236-125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pine Valley Integrated Services LLC | Current |
Accepting new patients | |
| Pine Valley Residential Services | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 12236-125 | WI | Yes |
Addresses
Primary practice location
124 Grayside Ave
Mauston, WI 53948-1913
Mailing address
124 Grayside Ave
Mauston, WI 53948-1913
Phone (608) 847-7575
Other providers in Mauston, WI
- Jacklyn Susan Abel
- Joanna Martyna Adamski
- Joseph Robert Agee-Aguayo
- Elisha Allen
- Anderson Chiropractic Office, SC
- Anderson Chiropractic Office,S.C.
- Allison Louise Anderson
- Katherine Andrews
All providers in Mauston, WI · Professional Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.