Individual provider Active NPI

Jeffrey T Kroening, MS LPC

  • Professional Counselor
  • Port Washington, WI
National Provider Identifier
1629054093
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1017125 Issued in WI
Practice address
101 E Pier St Ste 2
Port Washington, WI 53074-1943
Phone
(262) 284-5789
Fax
(262) 284-5907
NPI assigned
Dec 19, 2005
Last updated
Jul 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1017125 WI Primary

Addresses

Primary practice location

101 E Pier St Ste 2
Port Washington, WI 53074-1943

Mailing address

101 E Pier St Ste 2
Port Washington, WI 53074-1943
Phone (262) 284-5789

Other identifiers 1

IdentifierTypeStateIssuer
39544100MedicaidWI

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
I20231226001522 WI Practitioner - Mental Health Counselor 7911357439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Counseling ServicesGroup PAC ID 9234164153, 7 clinicians

Practice addresses (Care Compare)

101 E Pier St
Port Washington, WI 53074-1939
Phone (262) 284-5789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1017125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Counseling Services CurrentSince Jan 1, 2024 Accepting new patients
Bridgepoint Health LLC Past Accepting new patients

Locations

101 E Pier St
Prt Washingtn, WI 53074
Phone (262) 284-3117

101 E Pier St
Ste 2
Prt Washingtn, WI 53074
Phone (262) 284-5789

Organizations & group practices 2

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1629054093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E PIER ST STE 2",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530741943",
            "telephone_number": "262-284-5789",
            "fax_number": "262-284-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E PIER ST STE 2",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530741943",
            "telephone_number": "262-284-5789",
            "fax_number": "262-284-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROENING",
        "first_name": "JEFFREY",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "MS LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "1017125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39544100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Washington, WI

Sources for this page

Verify at the official NPI Registry.