Active NPI
Rebekah Lynn Wolff
- Professional Counselor
- Cedarburg, WI
National Provider Identifier
1891286043
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 7624-125
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891286043 | Medicaid | WI |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7624-125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kettle Moraine Counseling LLC | Current | Accepting new patients | |
| Hope'S Chariot, Inc. | Professional | Current | Accepting new patients |
| Affiliated Clinical Services Inc | Past | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Cedarburg, WI
- NPI 1194220863
Professional
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- West Bend, WI
- NPI 1568790954
-
- Multi-Specialty Clinic/Center
- West Bend, WI
- NPI 1851473698
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.