Individual provider Active NPI

Sue Larson, LPC CSAC

  • Professional Counselor
  • Richland Center, WI
National Provider Identifier
1457642126
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5548-125 Issued in WI
Practice address
149 E Mill St
Richland Center, WI 53581-2261
Phone
(608) 856-5225
NPI assigned
Apr 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15722-132 WI
Professional Counselor 101YP2500X 5548-125 WI Primary

Addresses

Primary practice location

149 E Mill St
Richland Center, WI 53581-2261

Mailing address

149 E Mill St
Richland Center, WI 53581-2261
Phone (608) 856-5225

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240503002472 WI Practitioner - Mental Health Counselor 9537509757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

149 E Mill St
Richland Center, WI 53581-2261
Phone (608) 856-5225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15722-132WIMDAddiction (Substance Use Disorder) Counselor
5548-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Day Counseling, LLC Addiction (Substance Use Disorder) CurrentSince Feb 18, 2024 Accepting new patients

Locations

149 E Mill St
Richland Center, WI 53581
Phone (608) 856-5225

130 S Central Ave
Ste 4
Richland Center, WI 53581

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1457642126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 E MILL ST",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535812261",
            "telephone_number": "608-856-5225",
            "fax_number": "608-856-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 E MILL ST",
            "city": "RICHLAND CENTER",
            "state": "WI",
            "postal_code": "535812261",
            "telephone_number": "608-856-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "SUE",
        "credential": "LPC CSAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-28",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15722-132",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5548-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland Center, WI

Sources for this page

Verify at the official NPI Registry.