NPIMap

Organization Active NPI

Kimberley Welk and Associates, LLC

  • Marriage & Family Therapist
  • Green Bay, WI
National Provider Identifier
1487075214
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
KIMBERLEY WELK AND ASSOCIATES, LLC
Practice address
926 Willard Dr Ste 136
Green Bay, WI 54304-5296
Phone
(920) 461-5820
Fax
(888) 449-6342
NPI assigned
Dec 20, 2013
Last updated
Oct 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Authorized official

Name
Ms. Kimberley M Welk, LMFTNPI 1891967303
Title
Owner
Phone
(920) 461-5820

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Marriage & Family Therapist 106H00000X NU Primary

Addresses

Primary practice location

926 Willard Dr Ste 136
Green Bay, WI 54304-5296

Mailing address

926 Willard Dr Ste 136
Green Bay, WI 54304-5296
Phone (920) 461-5820

Other identifiers 1

IdentifierTypeStateIssuer
43732400MedicaidWI

National Provider Directory

National Provider Directory

Locations

130 E Walnut St
Ste 607
Green Bay, WI 54301

926 Willard Dr
Ste 136
Green Bay, WI 54304
Phone (920) 460-9301

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635379200000",
    "number": "1487075214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 WILLARD DR STE 136",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045296",
            "telephone_number": "920-461-5820",
            "fax_number": "888-449-6342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 WILLARD DR STE 136",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045296",
            "telephone_number": "920-461-5820",
            "fax_number": "888-449-6342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLEY WELK AND ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-20",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A",
        "authorized_official_last_name": "WELK",
        "authorized_official_first_name": "KIMBERLEY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-461-5820",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43732400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.