Individual provider Active NPI

Rebecca Kathryn Kisley, MS, LPC, SAC

  • Professional Counselor
  • New London, WI
National Provider Identifier
1922526102
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6366-125 Issued in WI
Practice address
E7475 Rawhide Rd
New London, WI 54961-9025
Phone
(877) 300-9101
NPI assigned
Sep 7, 2017
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6366-125 WI Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 16130-131 WI

Addresses

Primary practice location

E7475 Rawhide Rd
New London, WI 54961-9025

Mailing address

E7475 Rawhide Rd
New London, WI 54961-9025
Phone (877) 300-9101

Other names 1

  • Rebecca Kathryn Heller Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
16130-131WIMDAddiction (Substance Use Disorder) Counselor
6366-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rawhide Inc. PastSince Jul 24, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rebecca.kisley@25254901.chartlogic.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1504742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1922526102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E7475 RAWHIDE RD",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549619025",
            "telephone_number": "877-300-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E7475 RAWHIDE RD",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549619025",
            "telephone_number": "877-300-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISLEY",
        "first_name": "REBECCA",
        "middle_name": "KATHRYN",
        "credential": "MS, LPC, SAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-07",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6366-125",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16130-131",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "HELLER",
            "middle_name": "KATHRYN",
            "credential": "MS, LPC, SAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New London, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.