Active NPI
Randall Kahn, LPC
- Mental Health Counselor
- Viroqua, WI
National Provider Identifier
1598826893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 3434-125
- Practice address
- 1321 N Main St
Viroqua, WI 54665-1156 - Phone
- (608) 637-7052
- Fax
- (608) 637-8500
- NPI assigned
- Dec 12, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 3434-125 | WI | Primary |
Addresses
Primary practice location
1321 N Main St
Viroqua, WI 54665-1156
Mailing address
1707 Main St
La Crosse, WI 54601-4200
Phone (608) 785-0001
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180323 | Medicaid | MN | |
| 40950200 | Medicaid | WI | |
| 39082186311 | Other | WI | UNITY HEALTH INSURANCE |
| HP69919 | Other | MN | HEALTHPARTNERS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3434-125 | WI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315785600000",
"number": "1598826893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1707 MAIN ST",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546014200",
"telephone_number": "608-785-0001",
"fax_number": "608-785-0002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1321 N MAIN ST",
"city": "VIROQUA",
"state": "WI",
"postal_code": "546651156",
"telephone_number": "608-637-7052",
"fax_number": "608-637-8500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAHN",
"first_name": "RANDALL",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2011-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WI",
"license": "3434-125",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "180323",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40950200",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITY HEALTH INSURANCE",
"identifier": "39082186311",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP69919",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Viroqua, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.