Individual provider Active NPI

Tara Taylor, LPC-IT

  • Professional Counselor
  • Sheboygan, WI
National Provider Identifier
1811407513
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7619-125 Issued in WI
Practice address
703 N 9TH St
Sheboygan, WI 53081-4515
Phone
(262) 233-1818
NPI assigned
Oct 7, 2017
Last updated
May 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 7619-125 WI Primary

Addresses

Primary practice location

703 N 9TH St
Sheboygan, WI 53081-4515

Mailing address

618 Roosevelt Rd
Kohler, WI 53044-1618
Phone (920) 917-5637

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
I20250519001283 WI Practitioner - Mental Health Counselor 3678091147 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Community Health Care, Inc CurrentSince Aug 18, 2025 Accepting new patients
Lakeshore Community Health Care, Inc Current Accepting new patients
Foundations of Community Living LLC CurrentSince Feb 1, 2022 Accepting new patients
Behavioral Health Clinic, LLC Professional CurrentSince May 12, 2025 Accepting new patients
Yurk Counseling Services Professional Past Accepting new patients

Locations

1245 Cheyenne Ave
Ste 200
Grafton, WI 53024
Phone (262) 233-1818

703 N 9th St
Sheboygan, WI 53081
Phone (262) 233-1818

2417 Post Rd
Stevens Point, WI 54481
Phone (715) 544-6144

630 S 36th Ave
Wausau, WI 54401
Phone (414) 301-1060

Organizations & group practices 5

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": "1507334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1811407513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 ROOSEVELT RD",
            "city": "KOHLER",
            "state": "WI",
            "postal_code": "530441618",
            "telephone_number": "920-917-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N 9TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530814515",
            "telephone_number": "262-233-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "TARA",
        "credential": "LPC-IT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-07",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7619-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

Verify at the official NPI Registry.