Diane Kay Anderson, LPC
Individual provider Active NPI Professional Counselor · Friendship, WI
NPI 1457311532 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1457311532
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 3450-125 (WI)
- Practice address
- 108 E North St
Friendship, WI 53934-9443 - Phone
- (608) 339-4511
- Fax
- (608) 339-4593
- NPI assigned
- Mar 24, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 1999
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1001 W Glen Oaks LN
Suite 105
Mequon, WI 53092-3369
329 Summit St
Portage, WI 53901-1542
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 |
|---|---|---|---|---|
| I20260205000278 | WI | Practitioner - Mental Health Counselor | 5092294595 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3450-125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corazon Counseling and Wellness | Current |
Accepting new patients |
Locations
1001 W Glen Oaks Ln
Ste 105
Mequon, WI 53092
Phone (414) 258-8314
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3450-125 | WI | Yes |
Addresses
Primary practice location
108 E North St
Friendship, WI 53934-9443
Mailing address
W8362 Royal Oaks Dr
Wautoma, WI 54982-5313
Phone (920) 787-0142
Other providers in Friendship, WI
- Adams Co Health & Human Serv
- Adams County Health and Human Services
- Ann M Anderson
- Aria at Villa Pines LLC
- Aspiring Horizons
- Virginia Lee Batie
- Kevin B. Beaver
- William D Borkon
All providers in Friendship, 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 Jul 13, 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.