NPIMap

Organization Active NPI

Calumet County

  • Mental Health Counselor
  • Chilton, WI
National Provider Identifier
1902898406
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1120 Issued in WI
Legal business name
CALUMET COUNTY
Practice address
206 Court St
Chilton, WI 53014-1127
Phone
(920) 849-1400
Fax
(920) 849-1468
NPI assigned
Aug 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Todd Romenesko
Title
County Administrator
Phone
(920) 849-1448

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 1120 WI
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 1120 WI Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 1120 WI

Addresses

Primary practice location

206 Court St
Chilton, WI 53014-1127

Mailing address

206 Court St
Chilton, WI 53014-1127
Phone (920) 849-1400

Other identifiers 3

IdentifierTypeStateIssuer
42137900MedicaidWV
43070800MedicaidWI
43425900MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060223000794 WI Part B Supplier - Clinic/Group Practice 1254347586 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Chilton, WI

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Calumet County Department of Human Services11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Calumet County HHC/Hospice AgencyChilton, WI, CCN 527085 Home health agency Operational/Managerial Control Jul 20, 1976
Home Healthcare/Hospice AgencyChilton, WI, CCN 521563 Hospice Operational/Managerial Control (100%) Nov 9, 1998

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699574400000",
    "number": "1902898406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 COURT ST",
            "city": "CHILTON",
            "state": "WI",
            "postal_code": "530141127",
            "telephone_number": "920-849-1400",
            "fax_number": "920-849-1468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 COURT ST",
            "city": "CHILTON",
            "state": "WI",
            "postal_code": "530141127",
            "telephone_number": "920-849-1400",
            "fax_number": "920-849-1468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALUMET COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-19",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A",
        "authorized_official_last_name": "ROMENESKO",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "COUNTY ADMINISTRATOR",
        "authorized_official_telephone_number": "920-849-1448",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "1120",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "1120",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "1120",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42137900",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43070800",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43425900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chilton, WI

Sources for this page

Verify at the official NPI Registry.