Raquel O Medrano

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4465-226 Issued in WI

Practice address

503 Wisconsin Ave Ste 2
Sheboygan, WI 53081-4147

Phone

(920) 458-5726

Fax

(920) 458-5826

NPI assigned

Oct 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeside Counseling Center, LLCGroup PAC ID 3577006758, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Lakeside Counseling Center, LLC

  • Mental Health Counselor
  • Madison, WI
  • NPI 1215443882
  Medicare reassignment Care Compare group NPD
• Catholic Charities of the Archdiocese of Milwaukee Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sheboygan, WI
  • NPI 1013990407
  NPD (past)
• Catholic Charities of the Archdiocese of Milwaukee Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Racine, WI
  • NPI 1619950011
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1861036295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WISCONSIN AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031526",
            "telephone_number": "262-637-8888",
            "fax_number": "262-637-0695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 WISCONSIN AVE STE 2",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530814147",
            "telephone_number": "920-458-5726",
            "fax_number": "920-458-5826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDRANO",
        "first_name": "RAQUEL",
        "middle_name": "O",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "4465-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Joy Meador, PT, DPT
• Amber K Meagher, NNP-MSN
• Meals on Wheels of Sheboygan County, Inc.
• Darlene Jean Mech, PH.D.
• Medical Hearing Associates, LTD
• Hannah Meerdink, APNP
• Jack E Meier, LPN
• Meijer Stores Limited Partnership (Meijer Pharmacy #305)
• Jason Meinhardt, DDS, MS
• Debra Meise, RDH

• Mental Health Counselor in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; 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.

Verify at the official NPI Registry.