Individual provider Active NPI

Kaitlyn Marie Villalpando, LPC

  • Professional Counselor
  • Kewaunee, WI
National Provider Identifier
1689195653
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7465-125 Issued in WI
Practice address
575 4TH St
Kewaunee, WI 54216-1785
Phone
(920) 388-4640
Fax
(920) 338-0479
NPI assigned
Jun 29, 2017
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3573-226 WI
Professional Counselor 101YP2500X 7465-125 WI Primary

Addresses

Primary practice location

575 4TH St
Kewaunee, WI 54216-1785

Mailing address

744 S Webster Ave
Medical Staff Services
Green Bay, WI 54301-3505

Other names 1

  • Ms. Kaitlyn Marie Miekle Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240311003689 WI Practitioner - Mental Health Counselor 6800246430 Reassigns benefits to 3 organizations
I20241003001083 MI Practitioner - Mental Health Counselor 6800246430 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bellin Memorial Hospital IncGroup PAC ID 8820900749, shared by 10 NPIs, 685 clinicians

Practice addresses (Care Compare)

440 Woodward Ave
Iron Mountain, MI 49801-4631
Phone (906) 776-9040

575 4TH St
Kewaunee, WI 54216-1785
Phone (920) 388-4640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3573-226WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Professional CurrentSince Aug 26, 2024 Accepting new patients
Oconto Hospital & Medical Center, Inc. CurrentSince Sep 26, 2024 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Sep 26, 2024 Accepting new patients
Oconto Hospital & Medical Center, Inc. Current Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Psychiatric Center Inc. Mental Health CurrentSince Aug 26, 2024 Accepting new patients
Oconto County Finance CurrentSince Jan 27, 2024 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Aug 26, 2024 Accepting new patients
Bellin Psychiatric Center Inc. Current Accepting new patients
Bellin Psychiatric Center Inc Current Accepting new patients

Locations

106 S School Rd
Daggett, MI 49821
Phone (906) 753-2155

610 S Lincoln Rd
Escanaba, MI 49829
Phone (906) 786-6488

440 Woodward Ave
Iron Mountain, MI 49801
Phone (906) 776-9040

1100 10th St
Menominee, MI 49858
Phone (906) 863-2256

301 Saint Joseph St
Green Bay, WI 54301
Phone (920) 430-3630

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

575 4th St
Kewaunee, WI 54216
Phone (920) 388-4640

501 Park Ave
Oconto, WI 54153
Phone (920) 834-6875

Organizations & group practices 11

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": "1498694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1689195653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 4TH ST",
            "city": "KEWAUNEE",
            "state": "WI",
            "postal_code": "542161785",
            "telephone_number": "920-388-4640",
            "fax_number": "920-338-0479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALPANDO",
        "first_name": "KAITLYN",
        "middle_name": "MARIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-29",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "3573-226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7465-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "MIEKLE",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kewaunee, WI

Sources for this page

Verify at the official NPI Registry.