Active NPI
Lindsey Mae Fergus-Renken, LPC
- Counselor
- Fond Du Lac, WI
National Provider Identifier
1649630419
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6861-125
- Practice address
- 459 E 1St St
Fond Du Lac, WI 54935-4505 - Phone
- (920) 929-3500
- NPI assigned
- Mar 7, 2016
- Last updated
- Apr 13, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6861-125 | WI | Primary |
Addresses
Primary practice location
459 E 1St St
Fond Du Lac, WI 54935-4505
Mailing address
2625 N Weil St
Milwaukee, WI 53212-3060
Phone (414) 962-1200
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6861-125 | WI | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fond Du Lac County DCP Crisis Intervention | Past | 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.
-
- Community/Behavioral Health Agency
- Fond Du Lac, WI
- NPI 1306969191
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586736000000",
"number": "1649630419",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 N WEIL ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532123060",
"telephone_number": "414-962-1200",
"fax_number": "414-962-2305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "459 E 1ST ST",
"city": "FOND DU LAC",
"state": "WI",
"postal_code": "549354505",
"telephone_number": "920-929-3500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERGUS-RENKEN",
"first_name": "LINDSEY",
"middle_name": "MAE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-07",
"last_updated": "2020-04-13",
"certification_date": "2020-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WI",
"license": "6861-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fond Du Lac, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.