Individual provider Active NPI

Christina Dame, LPC

  • Professional Counselor
  • Lake Geneva, WI
National Provider Identifier
1902259807
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5692 - 125 Issued in WI
Practice address
647 W Main St Ste 700
Lake Geneva, WI 53147-1997
Phone
(815) 236-9793
NPI assigned
Jul 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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 5692 - 125 WI Primary

Addresses

Primary practice location

647 W Main St Ste 700
Lake Geneva, WI 53147-1997

Mailing address

647 W Main St Ste 700
Lake Geneva, WI 53147-1997
Phone (815) 236-9793

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
5692 - 125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgelight Counseling Professional CurrentSince Feb 23, 2025 Accepting new patients
Bridgelight Counseling Professional CurrentSince Feb 23, 2025 Accepting new patients

Locations

647 W Main St
Ste 700
Lake Geneva, WI 53147
Phone (262) 321-8205

Organizations & group practices 2

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": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1902259807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 W MAIN ST STE 700",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471997",
            "telephone_number": "815-236-9793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 W MAIN ST STE 700",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471997",
            "telephone_number": "815-236-9793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAME",
        "first_name": "CHRISTINA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-15",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5692 - 125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Geneva, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.