Individual provider Active NPI

Kristen Ann Wlodek, LPC

  • Professional Counselor
  • Milwaukee, WI
National Provider Identifier
1609156488
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6107-125 Issued in WI
Practice address
210 W Capitol Dr
Milwaukee, WI 53212-1123
Phone
(414) 727-6320
Fax
(414) 727-6321
NPI assigned
Aug 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C3948 OR
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 6107-125 WI Primary

Addresses

Primary practice location

210 W Capitol Dr
Milwaukee, WI 53212-1123

Mailing address

210 W Capitol Dr
Milwaukee, WI 53212-1123
Phone (414) 727-6320

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
I20240209001271 WI Practitioner - Mental Health Counselor 4688017361 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C3948ORMDProfessional Counselor
6107-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Community Health Care, Inc Current Accepting new patients
Lakeshore Community Health Care, Inc. CurrentSince Dec 20, 2023 Accepting new patients
Lakeshore Community Health Care, Inc CurrentSince Dec 20, 2023 Accepting new patients

Locations

2719 Calumet Ave
Manitowoc, WI 54220
Phone (920) 686-2333

819 Kentucky Ave
Sheboygan, WI 53081
Phone (920) 783-6633

908 W Washington St
West Bend, WI 53095
Phone (262) 306-3500

Organizations & group practices 3

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": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1609156488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121123",
            "telephone_number": "414-727-6320",
            "fax_number": "414-727-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121123",
            "telephone_number": "414-727-6320",
            "fax_number": "414-727-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WLODEK",
        "first_name": "KRISTEN",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-24",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3948",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6107-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.