Individual provider Active NPI

Grace Nye

  • Professional Counselor
  • Kenosha, WI
National Provider Identifier
1639920515
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
11993-125 Issued in WI
Practice address
6121 Green Bay Rd Ste 200
Kenosha, WI 53142-2931
Phone
(262) 864-1141
NPI assigned
Mar 29, 2024
Last updated
Aug 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 19781-130 WI
Mental Health Counselor 101YM0800X 5404-226 WI
Professional Counselor 101YP2500X 11993-125 WI Primary

Addresses

Primary practice location

6121 Green Bay Rd Ste 200
Kenosha, WI 53142-2931

Mailing address

6121 Green Bay Rd Ste 200
Kenosha, WI 53142-2931
Phone (262) 864-1141

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
I20260428001232 WI Practitioner - Mental Health Counselor 0042787061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advance Clinical ServicesGroup PAC ID 4486156874, 4 clinicians

Practice addresses (Care Compare)

6121 Green Bay Rd
Suite 200
Kenosha, WI 53142-2931
Phone (262) 864-1141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19781-130WIMDAddiction (Substance Use Disorder) Counselor
5404-226WIMDMental Health Counselor
11993-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Clinical Services CurrentSince Mar 31, 2024 Accepting new patients

Locations

6121 Green Bay Rd
Ste 200
Kenosha, WI 53142
Phone (262) 694-3718

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": "1711670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1639920515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6121 GREEN BAY RD STE 200",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422931",
            "telephone_number": "262-864-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 GREEN BAY RD STE 200",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531422931",
            "telephone_number": "262-864-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYE",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-29",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "19781-130",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "5404-226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "11993-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.