Active NPI
Adrienne Stang
- Professional Counselor
- Oconomowoc, WI
National Provider Identifier
1932946753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 11154-125
- Practice address
- 405 E Forest St
Oconomowoc, WI 53066-3707 - Phone
- (262) 391-4978
- NPI assigned
- Jul 9, 2024
- 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 | 11154-125 | WI | Primary |
Addresses
Primary practice location
405 E Forest St
Oconomowoc, WI 53066-3707
Mailing address
450 Campus Dr Apt 510
Hartland, WI 53029-2569
Phone (262) 391-4978
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240913001547 | WI | Practitioner - Mental Health Counselor | 1759821960 | Practice locations: Oconomowoc, WI |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11154-125 | WI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720656000000",
"number": "1932946753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 CAMPUS DR APT 510",
"city": "HARTLAND",
"state": "WI",
"postal_code": "530292569",
"telephone_number": "262-391-4978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 E FOREST ST",
"city": "OCONOMOWOC",
"state": "WI",
"postal_code": "530663707",
"telephone_number": "262-391-4978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANG",
"first_name": "ADRIENNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-09",
"last_updated": "2024-07-11",
"certification_date": "2024-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "11154-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oconomowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.