Individual provider Active NPI

Natalie Marie Eddy, M.A.

  • Professional Counselor
  • Oak Creek, WI
National Provider Identifier
1770917957
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
7280 S 13TH St
Oak Creek, WI 53154-1831
Phone
(262) 334-4340
NPI assigned
Aug 24, 2013
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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 Primary

Addresses

Primary practice location

7280 S 13TH St
Oak Creek, WI 53154-1831

Mailing address

400 W River Dr
West Bend, WI 53090-1518
Phone (262) 334-4340

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
I20231221000868 WI Practitioner - Mental Health Counselor 5092165712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Kettle Moraine Counseling LLCGroup PAC ID 8527353747, 20 clinicians

Practice addresses (Care Compare)

400 W River Dr
West Bend, WI 53090-1518
Phone 262334434013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Kettle Moraine Counseling LLC CurrentSince Jan 1, 2024 Accepting new patients
Cedarburg Physical Therapy, Inc PastSince Aug 1, 2001 Accepting new patients
Affiliated Clinical Services Inc PastSince Oct 22, 2023 Accepting new patients

Locations

W62N281 Washington Ave
Cedarburg, WI 53012
Phone (262) 334-4340

400 W River Dr
West Bend, WI 53090
Phone (262) 334-4340

Organizations & group practices 3

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": "1377302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1770917957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W RIVER DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530901518",
            "telephone_number": "262-334-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7280 S 13TH ST",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531541831",
            "telephone_number": "262-334-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDDY",
        "first_name": "NATALIE",
        "middle_name": "MARIE",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-24",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Creek, WI

Sources for this page

Verify at the official NPI Registry.