NPIMap

Organization Active NPI

Clinic for Christian Counseling LLC

  • Community/Behavioral Health Agency
  • Eau Claire, WI
National Provider Identifier
1720135932
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
686-125 Issued in WI
Legal business name
CLINIC FOR CHRISTIAN COUNSELING LLC
Practice address
3410 Oakwood Mall Dr Ste 700
Eau Claire, WI 54701-2617
Phone
(715) 832-1678
Fax
(715) 832-6680
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Authorized official

Name
Mrs. Kimberly Jean Stein, LPCNPI 1518350347
Title
Owner
Phone
(715) 832-1678

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 686-125 WI Primary

Addresses

Primary practice location

3410 Oakwood Mall Dr Ste 700
Eau Claire, WI 54701-2617

Mailing address

3410 Oakwood Mall Dr Ste 700
Eau Claire, WI 54701-2617
Phone (715) 832-1678

Other identifiers 1

IdentifierTypeStateIssuer
39285200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110712000200 WI Part B Supplier - Clinic/Group Practice 0547438848 Receives reassigned benefits from 7 practitioners
Practice locations: Eau Claire, WI

National Provider Directory

National Provider Directory

Locations

3410 Oakwood Mall Dr
Ste 700
Eau Claire, WI 54701
Phone (715) 832-1678

3410 Oakwood Mall Dr
Eau Claire, WI 54701

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609718400000",
    "number": "1720135932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 OAKWOOD MALL DR STE 700",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547012617",
            "telephone_number": "715-832-1678",
            "fax_number": "715-832-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 OAKWOOD MALL DR STE 700",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547012617",
            "telephone_number": "715-832-1678",
            "fax_number": "715-832-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINIC FOR CHRISTIAN COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-832-1678",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "686-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39285200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.