NPIMap

Organization Active NPI

Peace of Mind Counseling LLC

  • Counselor
  • La Crosse, WI
National Provider Identifier
1861837692
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
3814-125 Issued in WI
Legal business name
PEACE OF MIND COUNSELING LLC
Practice address
115 5TH Ave S
Suite 507
La Crosse, WI 54601-9200
Phone
(608) 797-5679
NPI assigned
May 7, 2013
Last updated
Sep 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Authorized official

Name
Jay K Clark, LPC, LPCCNPI 1790962561
Title
Owner/Administrator
Phone
(608) 797-5679

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 3814-125 WI Primary

Addresses

Primary practice location

115 5TH Ave S
Suite 507
La Crosse, WI 54601-9200

Mailing address

115 5TH Avenue South
Suite 507
La Crosse, WI 54601
Phone (608) 797-5679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181114000157 WI Part B Supplier - Clinic/Group Practice 6305190166 Receives reassigned benefits from 20 practitioners
Practice locations: La Crosse, WI

National Provider Directory

National Provider Directory

Locations

920 Fillmore St
Black River Falls, WI 54615
Phone (715) 797-4141

1019 McHugh Rd
Holmen, WI 54636
Phone (608) 526-1310

115 5th Ave S
Ste 523
La Crosse, WI 54601
Phone (608) 397-0192

115 5th St S
Ste 507
La Crosse, WI 54601
Phone (608) 479-1325

401 Main St
Fl 5
La Crosse, WI 54601
Phone (608) 397-0192

806 Saint Paul St
La Crosse, WI 54603

103 S Water St
Sparta, WI 54656
Phone (608) 269-1588

230 Garland St W
West Salem, WI 54669

Practitioners & affiliated clinicians

Practitioners 61

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538006400000",
    "number": "1861837692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 5TH AVENUE SOUTH",
            "address_2": "SUITE 507",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "54601",
            "telephone_number": "608-797-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 5TH AVE S",
            "address_2": "SUITE 507",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546019200",
            "telephone_number": "608-797-5679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE OF MIND COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-07",
        "last_updated": "2018-09-27",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "608-797-5679",
        "authorized_official_credential": "LPC, LPCC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "3814-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.