Individual provider Active NPI

Kathleen George-Bol, LPC

  • Mental Health Counselor
  • Wausau, WI
National Provider Identifier
1801915988
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3298-125 Issued in WI
Practice address
114 Grand Ave
Wausau, WI 54403-6214
Phone
(715) 845-7175
Fax
(715) 845-7142
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3298-125 WI Primary

Addresses

Primary practice location

114 Grand Ave
Wausau, WI 54403-6214

Mailing address

114 Grand Ave
Wausau, WI 54403-6214
Phone (715) 845-7175

Other identifiers 1

IdentifierTypeStateIssuer
40951800MedicaidWI

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
I20240123003297 WI Practitioner - Mental Health Counselor 0941652168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Centre for Well-Being, IncGroup PAC ID 6002083920, 26 clinicians

Practice addresses (Care Compare)

901 N 6TH St
Wausau, WI 54403-4718
Phone (715) 848-5022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Law

State licenses

LicenseStateTypeSpecialty
3298-125WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Centre for Well-Being, Inc CurrentSince Jan 1, 2024 Accepting new patients
Elmergreen Associates,LLC PastSince Jul 1, 2015 Accepting new patients

Locations

901 N 6th St
Wausau, WI 54403
Phone (715) 848-5022

Organizations & group practices 2

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": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801915988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 GRAND AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036214",
            "telephone_number": "715-845-7175",
            "fax_number": "715-845-7142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 GRAND AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036214",
            "telephone_number": "715-845-7175",
            "fax_number": "715-845-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE-BOL",
        "first_name": "KATHLEEN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "3298-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40951800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.