Individual provider Active NPI

Andrea Lynn Paulin, LPC

  • Mental Health Counselor
  • Wisconsin Rapids, WI
National Provider Identifier
1609569367
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12724125 Issued in WI
Practice address
1210 Pepper Ave
Wisconsin Rapids, WI 54494-6415
Phone
(715) 286-9960
NPI assigned
May 30, 2023
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 12724125 WI Primary

Addresses

Primary practice location

1210 Pepper Ave
Wisconsin Rapids, WI 54494-6415

Mailing address

1210 Pepper Ave
Wisconsin Rapids, WI 54494-6415
Phone (715) 286-9960

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

LicenseStateTypeSpecialty
12724125WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Edmundson Counseling Mental Health CurrentSince Jun 4, 2023 Accepting new patients

Locations

420 3rd St S
Wisconsin Rapids, WI 54494
Phone (715) 424-3553

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1609569367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 PEPPER AVE",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544946415",
            "telephone_number": "715-286-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 PEPPER AVE",
            "city": "WISCONSIN RAPIDS",
            "state": "WI",
            "postal_code": "544946415",
            "telephone_number": "715-286-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULIN",
        "first_name": "ANDREA",
        "middle_name": "LYNN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "12724125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wisconsin Rapids, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.