Individual provider Active NPI

Karen T. Prochaska, LPC-SAS

  • Professional Counselor
  • Wausau, WI
National Provider Identifier
1700159217
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5013-125 Issued in WI
Practice address
630 S 36TH Ave
Wausau, WI 54401-3930
Phone
(715) 842-9500
Fax
(715) 848-0425
NPI assigned
Feb 14, 2012
Last updated
Jun 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 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 5013-125 WI Primary

Addresses

Primary practice location

630 S 36TH Ave
Wausau, WI 54401-3930

Mailing address

630 S 36TH Ave
Wausau, WI 54401-3930
Phone (715) 842-9500

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
I20240702001877 WI Practitioner - Mental Health Counselor 9234673179 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5013-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Clinic, LLC Professional CurrentSince Jun 18, 2024 Accepting new patients

Locations

2417 Post Rd
Stevens Point, WI 54481
Phone (715) 544-6144

630 S 36th Ave
Wausau, WI 54401
Phone (414) 301-1060

Organizations & group practices 1

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": "1329177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1700159217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S 36TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013930",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S 36TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544013930",
            "telephone_number": "715-842-9500",
            "fax_number": "715-848-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCHASKA",
        "first_name": "KAREN",
        "middle_name": "T.",
        "name_prefix": "Mrs.",
        "credential": "LPC-SAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-14",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5013-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.