Lynn Nowak, LPC, CSAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6584-125 Issued in WI

Practice address

715 Decorah Rd
West Bend, WI 53095-8112

Phone

(262) 305-9668

NPI assigned

Dec 27, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Midwest Wellness Inc.

  • Professional Counselor
  • West Bend, WI
  • NPI 1427834654
  Medicare reassignment NPD Authorized official
• Lakeshore Wellness and Recovery Inc

  • Professional Counselor
  • West Bend, WI
  • NPI 1609355452

  Addiction (Substance Use Disorder)

  NPD (past) Authorized official

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1962748624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 DECORAH RD",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530958112",
            "telephone_number": "262-305-9668",
            "fax_number": "262-416-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 DECORAH RD",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530958112",
            "telephone_number": "262-305-9668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1519 E Washington St Ste A",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "530952615",
            "country_code": "US",
            "telephone_number": "262-305-9668",
            "fax_number": "262-416-0085",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1228 Highway 33",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "53095",
            "country_code": "US",
            "telephone_number": "262-305-9668",
            "fax_number": "262-416-0085",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11512 W Port Washington Rd",
            "address_2": "Suite 201E",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "53092",
            "country_code": "US",
            "telephone_number": "262-305-9668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "121 W Main St",
            "address_purpose": "LOCATION",
            "city": "Port Washington",
            "state": "WI",
            "postal_code": "530741813",
            "country_code": "US",
            "telephone_number": "262-284-8157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOWAK",
        "first_name": "LYNN",
        "credential": "LPC, CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-27",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15917-132",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6584-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100027556",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962748624",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristine Ann Nigro, R.D. C.D.
• Miriam Ninmann, LMFT-IT
• Casey L Nolan, NP
• Joseph Nordin, DO
• Brian Novinska, MD
• Mark Y Nunag, M.D.
• Christine O'Callaghan, 17665-130
• Braeden O'Neill, DO
• Oakbrook Dental Group SC
• Oakbrook Dental, S.C.

• Professional Counselor in West Bend, WI
• Providers in West Bend, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.