Individual provider Active NPI

Annette Bale, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Kenosha, WI
National Provider Identifier
1639775281
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
16340-33 Issued in WI
Practice address
6525 Green Bay Rd Ste 2
Kenosha, WI 53142-2967
Phone
(262) 999-3495
Fax
(262) 821-6180
NPI assigned
Dec 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 16340-33 WI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 16340-33 WI Primary
Registered Nurse 163W00000X 121496-30 WI
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 041.273400 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209024477 IL

Addresses

Primary practice location

6525 Green Bay Rd Ste 2
Kenosha, WI 53142-2967

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630
Phone (262) 999-3495

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250509002351 WI Practitioner - Nurse Practitioner 0941693634 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
121496-30WIMDRegistered Nurse
041.273400ILMDAddiction (Substance Use Disorder) Registered Nurse
16340-33WIMDNurse Practitioner
209024477ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Counseling Services, Inc CurrentSince May 5, 2025 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

16535 W Bluemound Rd
Ste 200
Brookfield, WI 53005
Phone (262) 789-0909

6525 Green Bay Rd
Ste 2
Kenosha, WI 53142
Phone (262) 492-5276

10850 W Park Pl
Ste 100
Milwaukee, WI 53224
Phone (414) 361-4100

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.annettebale@149809.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1639775281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630",
            "telephone_number": "262-999-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6525 GREEN BAY RD STE 2",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422967",
            "telephone_number": "262-999-3495",
            "fax_number": "262-821-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALE",
        "first_name": "ANNETTE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-09",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "16340-33",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "16340-33",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "121496-30",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "041.273400",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209024477",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.