Molly C Skinner, LPC-IT AND SAC-IT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

16422 Issued in WI

Practice address

1111 W Wisconsin St
Sparta, WI 54656-2233

Phone

(608) 269-1588

NPI assigned

Nov 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gundersen Clinic LTDGroup PAC ID 9638082779, 422 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Gundersen Clinic LTD

  • Clinic/Center
  • La Crosse, WI
  • NPI 1851343115
  Medicare reassignment Care Compare group NPD
• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1225873458
  Medicare reassignment NPD
• Gundersen Clinic, LTD.

  • Clinic/Center
  • Tomah, WI
  • NPI 1497708044
  NPD
• Gundersen Lutheran Express Care, Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1043446974
  NPD
• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • Elm Grove, WI
  • NPI 1548992316
  NPD
• Gundersen Lutheran Medical Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567
  NPD

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1780152603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 MAIN ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014200",
            "telephone_number": "608-785-0001",
            "fax_number": "608-785-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W WISCONSIN ST",
            "city": "SPARTA",
            "state": "WI",
            "postal_code": "546562233",
            "telephone_number": "608-269-1588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1321 N Main St",
            "address_purpose": "LOCATION",
            "city": "Viroqua",
            "state": "WI",
            "postal_code": "546651156",
            "country_code": "US",
            "telephone_number": "608-637-7052",
            "fax_number": "608-637-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "MOLLY",
        "middle_name": "C",
        "credential": "LPC-IT AND SAC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "4177-226",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susette Marie Schmidt, R.N.
• Kristen K Schmitz, PTA
• Bhrett Morgan Schwartz, OTR/L, CLT
• Kelly Janell Seib, MD
• Tejal Jayant Shelat, MBBS, MPH
• Jessica L. Sosso, MD
• Sparta Area Ambulance Service LTD
• Sparta Area School District
• Sparta Chiropractic Clinic, LLC
• Sparta Dental Center SC

• Addiction (Substance Use Disorder) Counselor in Sparta, WI
• Providers in Sparta, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.