Joanne M Klysen

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6031-125 Issued in WI

Practice address

1061 W Mason St
Green Bay, WI 54303-1858

Phone

(920) 437-8256

Fax

(920) 437-1188

NPI assigned

Feb 11, 2014

Last updated

Jun 20, 2023By the provider in NPPES

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 1

Other names 1

• Joanne M Salm Former name

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, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Foundations Health and Wholeness IncGroup PAC ID 5597659631, 9 clinicians

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Foundations Health and Wholeness Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1497840607
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1962826941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 W MASON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543031858",
            "telephone_number": "920-437-8256",
            "fax_number": "920-437-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 W MASON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543031858",
            "telephone_number": "920-437-8256",
            "fax_number": "920-437-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLYSEN",
        "first_name": "JOANNE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-11",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "6031-125",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6031-125",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN DEPT OF SAFETY AND PROFESSIONAL SERVICES",
            "identifier": "6031-125",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANNE",
            "last_name": "SALM",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexandra Claire Klippel, PA-C
• Kristine A Klonowski, MS, CCC/SLP
• Janelle L Klubertanz, RN
• Kedra L Kluckey, APNP
• Elaine Catherine Kluth, LCSW
• Brian Allan Knapp, M.D.
• Zachary R Knapp, PT
• Jennifer Kneisler, COTA
• Sierra E Knier, SAC
• Teresa Lynn Kniess, O.T.R.

• Mental Health Counselor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.