Active NPI
Kristen Pavela, MSW, LCSW, MBA, CSAC
- Clinical Social Worker
- La Crosse, WI
National Provider Identifier
1861926008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 9369
- Practice address
- 700 West Ave South
La Crosse, WI 54601-8806 - Phone
- (608) 785-0940
- NPI assigned
- Apr 14, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 32878 | IL | |
| Clinical Social Worker | 1041C0700X | 9369 | WI | Primary |
Addresses
Primary practice location
700 West Ave South
La Crosse, WI 54601-8806
Mailing address
200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
Other practice location 1
505 N County Farm Rd
Wheaton, IL 60187-3907
Phone (630) 407-6341
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32878 | IL | MD | Addiction (Substance Use Disorder) Counselor |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- La Crosse, WI
- NPI 1629056049
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730419200000",
"number": "1861926008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 1ST ST SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559050001",
"telephone_number": "507-284-2511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 WEST AVE SOUTH",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546018806",
"telephone_number": "608-785-0940"
}
],
"practiceLocations": [
{
"address_1": "505 N County Farm Rd",
"address_purpose": "LOCATION",
"city": "Wheaton",
"state": "IL",
"postal_code": "601873907",
"country_code": "US",
"telephone_number": "630-407-6341",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAVELA",
"first_name": "KRISTEN",
"credential": "MSW, LCSW, MBA, CSAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-14",
"last_updated": "2024-11-01",
"certification_date": "2024-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IL",
"license": "32878",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "9369",
"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 Nov 1, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.