Individual provider Active NPI

Rebekah Lynn Wolff

  • Professional Counselor
  • Cedarburg, WI
National Provider Identifier
1891286043
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7624-125 Issued in WI
Practice address
695 State Road 60
Cedarburg, WI 53012-9201
Phone
(262) 305-8040
NPI assigned
May 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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 7624-125 WI Primary

Addresses

Primary practice location

695 State Road 60
Cedarburg, WI 53012-9201

Mailing address

695 State Road 60
Cedarburg, WI 53012-9201
Phone (262) 305-8040

Other practice location 1

400 W River Road
West Bend, WI 53090
Phone (262) 334-4340

Other practice location 2

13035 W Bluemound Rd Ste 100
Brookfield, WI 53005-8001
Phone (262) 784-1121

Other identifiers 1

IdentifierTypeStateIssuer
1891286043MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7624-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kettle Moraine Counseling LLC CurrentSince Apr 1, 2020 Accepting new patients
Hope'S Chariot, Inc. Professional CurrentSince Oct 1, 2023 Accepting new patients
Affiliated Clinical Services Inc PastSince Apr 1, 2020 Accepting new patients

Locations

400 W River Dr
West Bend, WI 53090
Phone (262) 334-4340

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1891286043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 STATE ROAD 60",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530129201",
            "telephone_number": "262-305-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 STATE ROAD 60",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530129201",
            "telephone_number": "262-305-8040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 W River Road",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "53090",
            "country_code": "US",
            "telephone_number": "262-334-4340",
            "fax_number": "262-334-4341",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13035 W Bluemound Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530058001",
            "country_code": "US",
            "telephone_number": "262-784-1121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "REBEKAH",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-23",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7624-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891286043",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.