Organization Active NPI

Halcyon Wellness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chippewa Falls, WI
National Provider Identifier
1639672108
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
4017-125 Issued in WI
Legal business name
HALCYON WELLNESS LLC
Practice address
345 Frenette Dr Ste 4
Chippewa Falls, WI 54729-3072
Phone
(715) 861-7762
Fax
(715) 861-7762
NPI assigned
Mar 12, 2018
Last updated
May 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Authorized official

Name
Regina M Lien, MS, LPCNPI 1740436823
Title
LLC Sole Member
Phone
(715) 861-7762

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 4017-125 WI Primary

Addresses

Primary practice location

345 Frenette Dr Ste 4
Chippewa Falls, WI 54729-3072

Mailing address

4905 157TH St
Chippewa Falls, WI 54729-9004
Phone (715) 723-4130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250805000693 WI Part B Supplier - Clinic/Group Practice 3375051949 Receives reassigned benefits from 3 practitioners
Practice locations: Chippewa Falls, WI

National Provider Directory

National Provider Directory

Locations

345 Frenette Dr
Ste 4
Chippewa Falls, WI 54729
Phone (715) 861-7762

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1520812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683158400000",
    "number": "1639672108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 157TH ST",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547299004",
            "telephone_number": "715-723-4130",
            "fax_number": "715-723-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 FRENETTE DR STE 4",
            "city": "CHIPPEWA FALLS",
            "state": "WI",
            "postal_code": "547293072",
            "telephone_number": "715-861-7762",
            "fax_number": "715-861-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALCYON WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-12",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A",
        "authorized_official_last_name": "LIEN",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "LLC SOLE MEMBER",
        "authorized_official_telephone_number": "715-861-7762",
        "authorized_official_credential": "MS, LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WI",
            "license": "4017-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chippewa Falls, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.