Mark A Stahl, MSE, CADC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2967-125 Issued in WI

Practice address

214 East Summer Street
Appleton, WI 54911

Phone

(920) 734-2601

Fax

(920) 727-1081

NPI assigned

Oct 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Mental Health Counselor

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Thedacare, IncorporatedGroup PAC ID 1759294887, 654 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Thedacare, Incorporated

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment Care Compare group NPD
• Thedacare, Incorporated

  • Counselor
  • Menasha, WI
  • NPI 1306959515
  NPD
• Catholic Charities of the Diocese of Green Bay Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1376769117
  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1760567184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 TAYCO STREET",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "54952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 EAST SUMMER STREET",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54911",
            "telephone_number": "920-734-2601",
            "fax_number": "920-727-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAHL",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "MSE, CADC, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "2967-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43566400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sue Srnka
• Allison R Stache, APNP
• Michelle B Stache, PTA
• Amy H Stack
• Richard A Staehler, MD
• Stairgoddess, LLC
• Allison L Stallbohm, APNP
• Mary Stample, APNP
• Roger Gary Stanek, D.D.S.
• Eric Jon Stanelle, M.D.

• Professional Counselor in Appleton, WI
• Providers in Appleton, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.