NPIMap

Organization Active NPI

Foundations Counseling Center, Inc.

  • Clinical Social Worker
  • Belleville, WI
National Provider Identifier
1659579928
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
FOUNDATIONS COUNSELING CENTER, INC.
Practice address
629 River St Ste C
Belleville, WI 53508-9189
Phone
(608) 424-9100
Fax
(608) 424-9099
NPI assigned
Jul 6, 2007
Last updated
Jul 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Authorized official

Name
Mrs. Alisa Colleen Kelly-Martina, LCSWNPI 1831223031
Title
Executive Co-Director
Phone
(608) 424-9100

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2508 WI
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

629 River St Ste C
Belleville, WI 53508-9189

Mailing address

629 River St Ste C
Belleville, WI 53508-9189
Phone (608) 445-0710

Other identifiers 1

IdentifierTypeStateIssuer
42234600MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250814001428 WI Part B Supplier - Clinic/Group Practice 3577062926 Receives reassigned benefits from 4 practitioners
Practice locations: Belleville, WI

National Provider Directory

National Provider Directory

Locations

619 River St
Ste F
Belleville, WI 53508
Phone (608) 424-9100

629 River St
Belleville, WI 53508
Phone (608) 424-9100

629 River St
Ste C
Belleville, WI 53508
Phone (608) 424-9100

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752537600000",
    "number": "1659579928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 RIVER ST STE C",
            "city": "BELLEVILLE",
            "state": "WI",
            "postal_code": "535089189",
            "telephone_number": "608-445-0710",
            "fax_number": "608-424-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 RIVER ST STE C",
            "city": "BELLEVILLE",
            "state": "WI",
            "postal_code": "535089189",
            "telephone_number": "608-424-9100",
            "fax_number": "608-424-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATIONS COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-06",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A",
        "authorized_official_last_name": "KELLY-MARTINA",
        "authorized_official_first_name": "ALISA",
        "authorized_official_middle_name": "COLLEEN",
        "authorized_official_title_or_position": "EXECUTIVE CO-DIRECTOR",
        "authorized_official_telephone_number": "608-424-9100",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "2508",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42234600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; 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.