Laurie Rae Reisener, LPC-IT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

8106-226 Issued in WI

Practice address

3703 N Murray Ave
Shorewood, WI 53211-2554

Phone

(414) 698-7776

NPI assigned

Sep 10, 2024

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

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

Specialty

Mental Health Counselor

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Pathways Counseling Center II LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Allis, WI
  • NPI 1942490438

  WI

  Medicare reassignment NPD (past)

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1689400210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3703 N MURRAY AVE",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112554",
            "telephone_number": "414-698-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 N MURRAY AVE",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112554",
            "telephone_number": "414-698-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISENER",
        "first_name": "LAURIE",
        "middle_name": "RAE",
        "credential": "LPC-IT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-10-07",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8106-226",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "8106-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sydney Prouty
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• Ray Ross Puppe, L.P.N.
• Reliant Senior Living LLC
• Stephanie Ann Rennicke
• Roselie Y Rentz, MSW, LCSW
• Elizabeth Roginski, O.D.
• Roots Counseling Services, LLC

• All providers in Shorewood, WI
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.