Active NPI
Nicole Klimowicz
- Professional Counselor
- Brown Deer, WI
National Provider Identifier
1801505409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 7412-226
- Practice address
- 3900 W Brown Deer Rd Ste 200
Brown Deer, WI 53209-1220 - Phone
- (414) 540-2170
- NPI assigned
- Nov 22, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 20062130 | WI | |
| Professional Counselor | 101YP2500X | 7412-226 | WI | Primary |
Addresses
Primary practice location
3900 W Brown Deer Rd Ste 200
Brown Deer, WI 53209-1220
Mailing address
3900 W Brown Deer Rd Ste 200
Brown Deer, WI 53209-1220
Phone (414) 540-2170
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3900 W Brown Deer Rd
Suite 200
Brown Deer, WI 53209-1220
Phone 4145402170256
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20062130 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 7412-226 | WI | MD | Professional Counselor |
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.
-
- Child & Adolescent Psychiatry Physician
- Milwaukee, WI
- NPI 1598800740
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695772800000",
"number": "1801505409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 W BROWN DEER RD STE 200",
"city": "BROWN DEER",
"state": "WI",
"postal_code": "532091220",
"telephone_number": "414-540-2170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 W BROWN DEER RD STE 200",
"city": "BROWN DEER",
"state": "WI",
"postal_code": "532091220",
"telephone_number": "414-540-2170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLIMOWICZ",
"first_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-22",
"last_updated": "2023-09-27",
"certification_date": "2023-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "20062130",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "7412-226",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brown Deer, WI
- Soo-in Kim
- Stacey King, LPC IT
- Robert Michael Kitsis, M.D.
- John Michael Kittelson, MSW, CAPSW
- Natalie Marie Klas, LMFT
- Bradley D Klinger, MA
- Jennifer Nell Klopfstein, M.D.
- KLS Community Outreach Teen Center Consulting and Management L.L.C.
- KLS Community Outreach Teen Center Consulting and Management L.L.C.
- Gerald William Knoch, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; 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.