Individual provider Active NPI

Jodi Ann Strebel-Dahl, MSED, LPC-IT

  • Professional Counselor
  • Green Bay, WI
National Provider Identifier
1790301414
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8501 Issued in WI
Practice address
626 S Irwin Ave
Green Bay, WI 54301-3304
Phone
(920) 436-6800
Fax
(920) 432-5966
NPI assigned
Jun 18, 2020
Last updated
May 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 8501 WI Primary
Professional Counselor 101YP2500X 4035-226 WI

Addresses

Primary practice location

626 S Irwin Ave
Green Bay, WI 54301-3304

Mailing address

PO Box 22308
Green Bay, WI 54305-2308
Phone (920) 436-6800

Other identifiers 2

IdentifierTypeStateIssuer
1790301414MedicaidWI
8501-125OtherWISTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4035-226WIMDProfessional Counselor
8501WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Services of Northeast Wi PastSince Jun 21, 2020 Accepting new patients
Family Services of Northeast Wisconsin Inc PastSince Jun 21, 2020 Accepting new patients
Family Services of Northeast Wisconsin Inc PastSince Jun 21, 2020 Accepting new patients

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": "1592438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1790301414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22308",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052308",
            "telephone_number": "920-436-6800",
            "fax_number": "920-432-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 S IRWIN AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013304",
            "telephone_number": "920-436-6800",
            "fax_number": "920-432-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREBEL-DAHL",
        "first_name": "JODI",
        "middle_name": "ANN",
        "credential": "MSED, LPC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-18",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8501",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4035-226",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790301414",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "8501-125",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.