Andrea Guenther-Pal, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8865-123 Issued in WI

Practice address

1835 E Edgewood Dr Ste 105-470
Appleton, WI 54913-9407

Phone

(920) 944-9700

Fax

(920) 570-6990

NPI assigned

Jun 23, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 22, 2023 through Dec 22, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Purple Lotus Counseling LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Appleton, WI
  • NPI 1720550981
  NPD (past)

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1669823381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 E EDGEWOOD DR STE 105-470",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139407",
            "telephone_number": "920-944-9700",
            "fax_number": "920-570-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 E EDGEWOOD DR STE 105-470",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549139407",
            "telephone_number": "920-944-9700",
            "fax_number": "920-570-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUENTHER-PAL",
        "first_name": "ANDREA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8856-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8865-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle L Gruenstern, RN
• Joseph Frederick Grycowski, PHARM D
• Rachael E Grzywa, OTR/L
• Nancy L Gudex, NP
• Amanda M Gueldenzopf, LPC
• Sierra Guenther, MSN, FNP
• William C Guenther Jr., M.D.
• Andrea Lane Guerrero, RN
• Kerri Elizabeth Guillen
• Jamee Guillory

• Clinical Social Worker in Appleton, WI
• Providers in Appleton, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.