Individual provider Active NPI

Kathryn Zellner, LPC, SAC

  • Professional Counselor
  • Menomonie, WI
National Provider Identifier
1780158592
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8216-125 Issued in WI
Practice address
800 Wilson Ave RM 330
Menomonie, WI 54751-2746
Phone
(715) 256-7166
Fax
(888) 427-8048
NPI assigned
Jan 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 18525-130 WI
Mental Health Counselor 101YM0800X 4257-226 WI
Professional Counselor 101YP2500X 8216-125 WI Primary

Addresses

Primary practice location

800 Wilson Ave RM 330
Menomonie, WI 54751-2746

Mailing address

800 Wilson Ave RM 330
Menomonie, WI 54751-2746
Phone (715) 256-7166

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
I20260325001696 WI Practitioner - Mental Health Counselor 3779067905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

800 Wilson Ave
RM 330
Menomonie, WI 54751-2746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18525-130WIMDAddiction (Substance Use Disorder) Counselor
4257-226WIMDMental Health Counselor
8216-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Psychological and Consulting Services LLC Professional CurrentSince Dec 6, 2022 Accepting new patients

Locations

800 Wilson Ave
Rm 330
Menomonie, WI 54751
Phone (715) 256-7166

Organizations & group practices 1

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": "1547510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1780158592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WILSON AVE RM 330",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512746",
            "telephone_number": "715-256-7166",
            "fax_number": "888-427-8048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WILSON AVE RM 330",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547512746",
            "telephone_number": "715-256-7166",
            "fax_number": "888-427-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELLNER",
        "first_name": "KATHRYN",
        "credential": "LPC, SAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-15",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "18525-130",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "4257-226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8216-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonie, WI

Sources for this page

Verify at the official NPI Registry.