Individual provider Active NPI

Kalie Bach, MS, LPC-IT, NCC

  • Mental Health Counselor
  • Watertown, WI
National Provider Identifier
1497644157
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
818 West St Ste 814
Watertown, WI 53094-1201
Phone
(920) 545-4357
NPI assigned
Jun 30, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

818 West St Ste 814
Watertown, WI 53094-1201

Mailing address

612 Sweetbriar LN
Watertown, WI 53098-1200

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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Mental Health Services, LLC Mental Health CurrentSince Jul 9, 2025 Accepting new patients
Inner Haven Wellness LLC PastSince Jul 9, 2025 Accepting new patients

Locations

818 West St
Ste 814
Watertown, WI 53094
Phone (920) 306-2174

Organizations & group practices 2

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": "1751241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1497644157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 SWEETBRIAR LN",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530981200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 WEST ST STE 814",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530941201",
            "telephone_number": "920-545-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACH",
        "first_name": "KALIE",
        "credential": "MS, LPC-IT, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.