Individual provider Active NPI

Panou Lee

  • Professional Counselor
  • Waupun, WI
National Provider Identifier
1891421392
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
620 W Brown St
Waupun, WI 53963-1702
Phone
(920) 324-7600
NPI assigned
Jul 27, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 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 Primary

Addresses

Primary practice location

620 W Brown St
Waupun, WI 53963-1702

Mailing address

620 W Brown St
Waupun, WI 53963-1702

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250620000698 WI Practitioner - Mental Health Counselor 5092227629 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11831WIMDPharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Agnesian Healthcare, Inc CurrentSince Jun 2, 2025 Accepting new patients
Agnesian Healthcare Inc CurrentSince Jun 2, 2025 Accepting new patients
Agnesian Healthcare Inc Past Accepting new patients

Locations

401 S Military Rd
Fond du Lac, WI 54935
Phone (920) 906-6660

109 E Merrill Ave
Fond du Lac, WI 54935

101 Morningside Dr
Fond du Lac, WI 54935

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

72 W 9th St
Fond du Lac, WI 54935
Phone (920) 906-6520

430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

620 W Brown St
Waupun, WI 53963
Phone (920) 324-5581

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": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1891421392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W BROWN ST",
            "city": "WAUPUN",
            "state": "WI",
            "postal_code": "539631702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 W BROWN ST",
            "city": "WAUPUN",
            "state": "WI",
            "postal_code": "539631702",
            "telephone_number": "920-324-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "PANOU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waupun, WI

Sources for this page

Verify at the official NPI Registry.