Isabelle Wangerin
Individual provider Active NPI Mental Health Counselor · Walworth, WI
NPI 1760162960 · NPPES record last updated Jul 21, 2023
Key facts
- NPI
- 1760162960
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 7462-226 (WI)
- Practice address
- 129 Kenosha St
Walworth, WI 53184 - Phone
- (262) 607-2770
- NPI assigned
- Jul 21, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Center for Change, LLC
Practice addresses (Care Compare)
129 Kenosha St
Walworth, WI 53184-9642
Phone (262) 607-2770
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251107000531 | WI | Practitioner - Mental Health Counselor | 7113417163 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7462-226 | WI | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Change, LLC | Mental Health | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 7462-226 | WI | Yes |
Addresses
Primary practice location
129 Kenosha St
Walworth, WI 53184
Mailing address
105 E Green St
Watertown, WI 53098-2821
Phone (920) 248-3596
Other providers in Walworth, WI
- Daniel William Rankin
- Lindsey E Tuntland
- Jennifer L Van Vleet
- Village of Walworth
- Walworth Elementary School
- Carol Anne Weikel
- Glenn Alan Wergin
- WSSH Powerback Rehabilitation Services, LLC
- Jessica Young
- Krysta Zarnstorff
All providers in Walworth, WI · Mental Health Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.