Individual provider Active NPI

Nancy J Stinemyer-Dietz, LPC

  • Professional Counselor
  • Janesville, WI
National Provider Identifier
1649939497
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
11341 Issued in WI
Practice address
17 S River St Ste 254
Janesville, WI 53548-3863
Phone
(608) 755-5260
NPI assigned
Dec 9, 2021
Last updated
Oct 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 11341 WI Primary

Addresses

Primary practice location

17 S River St Ste 254
Janesville, WI 53548-3863

Mailing address

17 S River St Ste 254
Janesville, WI 53548-3863
Phone (608) 755-5260

Other names 1

  • Nancy Stinemyer Former name

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
I20241127001488 WI Practitioner - Mental Health Counselor 0446785497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Trivium LLCGroup PAC ID 6800115676, 12 clinicians

Practice addresses (Care Compare)

17 S River St
Suite 254
Janesville, WI 53548-3863
Phone 60875552601215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11341WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Trivium LLC CurrentSince Nov 20, 2024 Accepting new patients
Trivium LLC PastSince Dec 12, 2021 Accepting new patients

Locations

17 S River St
Ste 254
Janesville, WI 53548
Phone (608) 755-5260

Organizations & group practices 2

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": "1639008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1649939497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 S RIVER ST STE 254",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535483863",
            "telephone_number": "608-755-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 S RIVER ST STE 254",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535483863",
            "telephone_number": "608-755-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINEMYER-DIETZ",
        "first_name": "NANCY",
        "middle_name": "J",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-09",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "11341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "STINEMYER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.