Active NPI
Kristen Louise Radtke, LPC-IT, CMI
- Professional Counselor
- Madison, WI
National Provider Identifier
1609244763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2653-226
- Practice address
- 429 Gammon PL
Suite 200
Madison, WI 53719-1053 - Phone
- (815) 520-6023
- Fax
- (608) 821-0938
- NPI assigned
- Sep 7, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2653-226 | WI | Primary |
Addresses
Primary practice location
429 Gammon PL
Suite 200
Madison, WI 53719-1053
Mailing address
429 Gammon PL
Suite 200
Madison, WI 53719-1053
Phone (815) 520-6023
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2653-226 | WI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469059200000",
"number": "1609244763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "429 GAMMON PL",
"address_2": "SUITE 200",
"city": "MADISON",
"state": "WI",
"postal_code": "537191053",
"telephone_number": "815-520-6023",
"fax_number": "608-821-0938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "429 GAMMON PL",
"address_2": "SUITE 200",
"city": "MADISON",
"state": "WI",
"postal_code": "537191053",
"telephone_number": "815-520-6023",
"fax_number": "608-821-0938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADTKE",
"first_name": "KRISTEN",
"middle_name": "LOUISE",
"credential": "LPC-IT, CMI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-07",
"last_updated": "2016-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "2653-226",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.