Shawne Nicole Judnic, MS, LPC
Individual provider Active NPI Professional Counselor · Wittenberg, WI
NPI 1851690937 · NPPES record last updated Mar 15, 2011
Key facts
- NPI
- 1851690937
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 4264-125 (WI)
- Practice address
- W18105 Hemlock Rd
Wittenberg, WI 54499-8647 - Phone
- (715) 253-2116
- NPI assigned
- Mar 15, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2006
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
111 W Jackson St
Wisconsin Rapids, WI 54495-2702
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260216000285 | WI | Practitioner - Mental Health Counselor | 0749760122 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4264-125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Wood | Current |
Accepting new patients | |
| County of Wood | Professional | Current |
Accepting new patients |
| Lutheran Social Services of Wisconsin and Upper Michigan, Inc. | Past | Accepting new patients |
Locations
111 W Jackson St
Wisconsin Rapids, WI 54495
Phone (715) 421-8820
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4264-125 | WI | Yes |
Addresses
Primary practice location
W18105 Hemlock Rd
Wittenberg, WI 54499-8647
Mailing address
5341 Spruce Ave
Wisconsin Rapids, WI 54494-8175
Phone (715) 325-6914
Other providers in Wittenberg, WI
- Nichol M Hermel
- Ho Chunk Nation
- Homme Home for the Aging Inc.
- Joan Ostermeier Physical Therapy Limited Partnerhsip
- Joan Ostermeier Physical Therapy Limited Partnership
- Karleen Kemp
- Andrea Kramer
- Mikayla Danielle Kriha
- Steven Thomas Lechner
- Long Chiropractic Center SC
All providers in Wittenberg, WI · Professional 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 Mar 15, 2011. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.