Individual provider Active NPI

Jennifer W Kwapil, LPC, SAC IT

  • Professional Counselor
  • Watertown, WI
National Provider Identifier
1629550116
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7042-125 Issued in WI
Practice address
1315 W Main St
Watertown, WI 53094-3564
Phone
(920) 261-4100
NPI assigned
Aug 31, 2018
Last updated
Aug 31, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 18432-130 WI
Professional Counselor 101YP2500X 7042-125 WI Primary

Addresses

Primary practice location

1315 W Main St
Watertown, WI 53094-3564

Mailing address

1121 Bayberry Dr
Watertown, WI 53098-3220
Phone (920) 248-6845

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
18432-130WIMDAddiction (Substance Use Disorder) Counselor
7042-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Resources Associates Inc PastSince Jun 23, 2004 Accepting new patients

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": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1629550116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 BAYBERRY DR",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530983220",
            "telephone_number": "920-248-6845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 W MAIN ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530943564",
            "telephone_number": "920-261-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAPIL",
        "first_name": "JENNIFER",
        "middle_name": "W",
        "credential": "LPC, SAC IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "18432-130",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7042-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; 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.