Stacie Nagorski, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6468-125 Issued in WI

Practice address

4351 W College Ave Ste 410
Appleton, WI 54914

Phone

(800) 438-1772

Fax

(262) 345-5562

NPI assigned

Dec 1, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI, MN2 enrollments

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 2

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wisconsin Lutheran Child and Family Service IncGroup PAC ID 0749233898, 35 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Wisconsin Lutheran Child and Family Service Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Germantown, WI
  • NPI 1083786628

  MN, Professional

  Medicare reassignment Care Compare group NPD
• Wisconsin Lutheran Child & Family Service, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Appleton, WI
  • NPI 1750475513

  Professional

  NPD (past)
• Wisconsin Lutheran Child & Family Service

  • Psychologist
  • Mankato, MN
  • NPI 1801271515

  Professional

  NPD (past)

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1588039663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 REVERE RD",
            "city": "PLOVER",
            "state": "WI",
            "postal_code": "544673631",
            "telephone_number": "715-570-7267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4351 W COLLEGE AVE STE 410",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54914",
            "telephone_number": "800-438-1772",
            "fax_number": "262-345-5562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 W Grand Ave Ste 304A",
            "address_purpose": "LOCATION",
            "city": "Wisconsin Rapids",
            "state": "WI",
            "postal_code": "544952781",
            "country_code": "US",
            "telephone_number": "715-570-7267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAGORSKI",
        "first_name": "STACIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-01",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6468-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10049991",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzan L. Myhre, MSSW
• Tammy Myhre
• Jason Robert Myrick, PA-C
• Diane Nackers
• Jaclyn Nagan, MS CCC-SLP
• Daniel E Natali, PHD
• Lisa Marie Nate, RPH
• National Seating & Mobility Inc
• Natural Tresses LLC
• Gabriel Nazario del Toro

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.