Brooke T Kysely, MS, LPC, NCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

8573-125 Issued in WI

Practice address

1541 Annex Rd
Jefferson, WI 53549-9803

Phone

(206) 741-1349

NPI assigned

Feb 11, 2021

Last updated

Jan 29, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jefferson County

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jefferson, WI
  • NPI 1275614919
  NPD
• Jefferson County

  dba Jefferson County Human Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jefferson, WI
  • NPI 1578562286
  NPD
• Affiliated Counseling Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Beaver Dam, WI
  • NPI 1164568879
  NPD (past)

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674950400000",
    "number": "1487247326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 ANNEX RD",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535499803",
            "telephone_number": "920-318-2095",
            "fax_number": "920-887-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 ANNEX RD",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535499803",
            "telephone_number": "206-741-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYSELY",
        "first_name": "BROOKE",
        "middle_name": "T",
        "credential": "MS, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-11",
        "last_updated": "2023-01-29",
        "certification_date": "2023-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "4834226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8573-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "blee@jeffersoncountywi.gov",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1541 Annex Rd",
            "city": "Jefferson",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535499803",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "bkysely@jeffersoncountywi.gov",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1541 Annex Rd",
            "city": "Jefferson",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535499803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alicia Kraucunas
• Abigail Jane Krueger, MS, CCC-SLP
• Cory R Krueger, MS, LPC-IT, SAC-IT
• Kari Lynn Kuffer, MS
• Melanie Agnes Kutz, R.N.
• Betsy Lane, LPC, CSAC
• Shayna Kelly Lang, MSW
• Art Leavens
• Nicole Lemanski
• Lewis Health Enterprises LLC (Central Jefferson Chiropractic)

• Professional Counselor in Jefferson, WI
• Providers in Jefferson, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.