Active NPI
Ryan D Knutson, CSAC, LPC, ICS-IT
- Professional Counselor
- Onalaska, WI
National Provider Identifier
1497296461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2777
- Practice address
- 571 Braund St
Onalaska, WI 54650 - Phone
- (608) 785-7000
- Fax
- (608) 785-7477
- NPI assigned
- Mar 10, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 16064 | WI | |
| Professional Counselor | 101YP2500X | 2777 | WI | Primary |
Addresses
Primary practice location
571 Braund St
Onalaska, WI 54650
Mailing address
1333 Travis St
La Crosse, WI 54601-6343
Phone (608) 386-6080
Other practice location 1
1707 Main St
LA Crosse, WI 54601-4200
Phone (608) 785-0001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100065209 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16064 | WI | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stein Counseling and Consulting Services, LTD. | Past | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Onalaska, WI
- NPI 1861592891
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532304000000",
"number": "1497296461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1333 TRAVIS ST",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546016343",
"telephone_number": "608-386-6080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "571 BRAUND ST",
"city": "ONALASKA",
"state": "WI",
"postal_code": "54650",
"telephone_number": "608-785-7000",
"fax_number": "608-785-7477"
}
],
"practiceLocations": [
{
"address_1": "1707 Main St",
"address_purpose": "LOCATION",
"city": "LA Crosse",
"state": "WI",
"postal_code": "546014200",
"country_code": "US",
"telephone_number": "608-785-0001",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KNUTSON",
"first_name": "RYAN",
"middle_name": "D",
"credential": "CSAC, LPC, ICS-IT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-10",
"last_updated": "2018-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "16064",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "2777",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100065209",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Onalaska, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.