Individual provider Active NPI

Josie Anne Wacker, LCPC

  • Professional Counselor
  • Salina, KS
National Provider Identifier
1700379609
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
03206 Issued in KS
Practice address
809 Elmhurst Blvd
Salina, KS 67401-7428
Phone
(785) 823-6322
Fax
(785) 823-3109
NPI assigned
Jun 14, 2018
Last updated
Jan 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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 03206 KS Primary

Addresses

Primary practice location

809 Elmhurst Blvd
Salina, KS 67401-7428

Mailing address

809 Elmhurst Blvd
Salina, KS 67401-7428
Phone (785) 823-6322

Other identifiers 1

IdentifierTypeStateIssuer
201201820AMedicaidKS

Other names 1

  • Josie Anne Peterson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20231122001173 KS Practitioner - Mental Health Counselor 5799133229 Reassigns benefits to 1 organization

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
Central Kansas Mental Health CenterGroup PAC ID 7315921434, 17 clinicians

Practice addresses (Care Compare)

809 Elmhurst Blvd
Salina, KS 67401-7405
Phone (785) 823-6322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03206KSMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Kansas Mental Health Center CurrentSince Jan 1, 2024 Accepting new patients

Locations

420 NE 10th St
Abilene, KS 67410
Phone (785) 263-3999

1602 Aylward Ave
Ellsworth, KS 67439
Phone (785) 472-3111

114 W Court St
Lincoln, KS 67455
Phone (785) 524-4406

817A Argyle Ave
Minneapolis, KS 67467
Phone (785) 392-2822

809 Elmhurst Blvd
Salina, KS 67401
Phone (785) 823-6322

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": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1700379609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 ELMHURST BLVD",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674017428",
            "telephone_number": "785-823-6322",
            "fax_number": "785-823-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 ELMHURST BLVD",
            "city": "SALINA",
            "state": "KS",
            "postal_code": "674017428",
            "telephone_number": "785-823-6322",
            "fax_number": "785-823-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WACKER",
        "first_name": "JOSIE",
        "middle_name": "ANNE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "03206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201201820A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOSIE",
            "last_name": "PETERSON",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salina, KS

Sources for this page

Verify at the official NPI Registry.