Jodi Lynn Huebner, MA, LPC
Individual provider Active NPI Mental Health Counselor · Appleton, WI
NPI 1811216484 · NPPES record last updated May 21, 2010
Key facts
- NPI
- 1811216484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 4185-125 (WI)
- Practice address
- 1045 N Lynndale Dr Ste 2D
Appleton, WI 54914-3048 - Phone
- (920) 475-0246
- NPI assigned
- May 21, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 23, 2024 through Apr 23, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4185-125 | WI | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4185-125 | WI | Yes |
Addresses
Primary practice location
1045 N Lynndale Dr Ste 2D
Appleton, WI 54914-3048
Mailing address
1045 N Lynndale Dr Ste 2D
Appleton, WI 54914-3048
Phone (920) 475-0246
NPI Registry JSON
{
"created_epoch": "1274400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274400000000",
"number": "1811216484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1045 N LYNNDALE DR STE 2D",
"city": "APPLETON",
"state": "WI",
"postal_code": "549143048",
"telephone_number": "920-475-0246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1045 N LYNNDALE DR STE 2D",
"city": "APPLETON",
"state": "WI",
"postal_code": "549143048",
"telephone_number": "920-475-0246"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUEBNER",
"first_name": "JODI",
"middle_name": "LYNN",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-21",
"last_updated": "2010-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WI",
"license": "4185-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
- Jennifer Miller Houtz
- Fran L. Hubbard
- Kathryn Gunn Huber
- Paula R Hubert
- Roderick Landon Hubert
- Paul Huebner
- Bridget S Huenink
- Kelly Lynn Huenink
- Stephanie L Hueseman
- Shannon L. Huettl
All providers in Appleton, WI · Mental Health Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.