Kelly Lyn Misfeldt, CSW CSAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

15451-132 Issued in WI

Practice address

2661 County Highway I
Chippewa Falls, WI 54729-5407

Phone

(715) 723-5585

NPI assigned

Jun 7, 2012

Last updated

Jun 7, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1528329315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2661 COUNTY HIGHWAY I",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547295407",
            "telephone_number": "715-723-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2661 COUNTY HIGHWAY I",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547295407",
            "telephone_number": "715-723-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISFELDT",
        "first_name": "KELLY",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "CSW CSAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15451-132",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "8511-120",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "15451-132",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "8511-120",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Lynn Millard, PA-C
• Brianna Marie Miller
• Christine A Miller
• Vincent T Miller, MD
• Minneapolis Vamc
• Kenneth R Mitchell, MD
• Tracy Angelique Moe, APNP
• John C Moffitt, MD
• Tamara L Mohr
• Denise Molloy

• Addiction (Substance Use Disorder) Counselor in Chippewa Falls, WI
• Providers in Chippewa Falls, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; 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.