Individual provider Active NPI

Candice Lynn Lipski, MS

  • School Counselor
  • Glendale, WI
National Provider Identifier
1578891107
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
School CounselorTaxonomy code 101YS0200X
License
699753 Issued in WI
Practice address
6310 N Port Washington Rd
Glendale, WI 53217-4300
Phone
(414) 961-1600
NPI assigned
Nov 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Counselor 101YS0200X 699753 WI Primary

Addresses

Primary practice location

6310 N Port Washington Rd
Glendale, WI 53217-4300

Mailing address

6310 N Port Washington Rd
Glendale, WI 53217-4300
Phone (414) 961-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240430001444 WI Practitioner - Mental Health Counselor 8921281759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Abg Wellness Group IncGroup PAC ID 0345536785, 16 clinicians

Practice addresses (Care Compare)

11414 W Park PL
Suite 202
Milwaukee, WI 53224-3500
Phone (414) 292-7060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
699753WIMDSchool Counselor
4729WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Abg Wellness Group Inc CurrentSince Mar 29, 2024 Accepting new patients

Locations

11414 W Park Pl
Ste 202
Milwaukee, WI 53224
Phone (414) 292-7060

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.

NPI Registry JSON

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1578891107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6310 N PORT WASHINGTON RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174300",
            "telephone_number": "414-961-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6310 N PORT WASHINGTON RD",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174300",
            "telephone_number": "414-961-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPSKI",
        "first_name": "CANDICE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-19",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "WI",
            "license": "699753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

Verify at the official NPI Registry.