Individual provider Active NPI

Katherine Cottrill

  • Professional Counselor
  • Beloit, WI
National Provider Identifier
1750895447
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3621-226 Issued in WI
Practice address
1969 W Hart Rd
Beloit, WI 53511-2230
Phone
(815) 378-8258
NPI assigned
Nov 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 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 3621-226 WI Primary

Addresses

Primary practice location

1969 W Hart Rd
Beloit, WI 53511-2230

Mailing address

1919 Stratford LN
Rockford, IL 61107-1369
Phone (815) 378-8258

Other identifiers 1

IdentifierTypeStateIssuer
1750895447MedicaidWI

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
I20241122000645 WI Practitioner - Mental Health Counselor 8123553567 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3621-226WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Beloit Health System Inc CurrentSince Sep 15, 2024 Accepting new patients
Beloit Health System, Inc CurrentSince Sep 15, 2024 Accepting new patients
Beloit Health System, Inc Past Accepting new patients
Children'S Service Society of Wisconsin Professional PastSince Jul 1, 2022 Accepting new patients

Locations

1905 E Huebbe Pkwy
Beloit, WI 53511
Phone (608) 364-2293

1225 4th St
Beloit, WI 53511
Phone (608) 361-3032

1969 W Hart Rd
Beloit, WI 53511
Phone (608) 364-5011

1735 Madison Rd
Beloit, WI 53511
Phone (608) 363-7510

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1750895447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 STRATFORD LN",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071369",
            "telephone_number": "815-378-8258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1969 W HART RD",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535112230",
            "telephone_number": "815-378-8258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTRILL",
        "first_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-17",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3621-226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750895447",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beloit, WI

Sources for this page

Verify at the official NPI Registry.