Carissa Weber, LPC, CSAC
Individual provider Active NPI Professional Counselor · Baileys Harbor, WI
NPI 1962889436 · NPPES record last updated Jan 28, 2026
Key facts
- NPI
- 1962889436
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 5464-125 (WI)
- Practice address
- 7387 Logerquist Rd
Baileys Harbor, WI 54202-9610 - Phone
- (715) 451-7530
- Fax
- (715) 848-8665
- NPI assigned
- May 4, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2010
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
7387 Logerquist Rd
Baileys Harbor, WI 54202-9610
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241031003224 | WI | Practitioner - Mental Health Counselor | 6901339779 | Practice locations: Baileys Harbor, WI |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15875-132 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 5464 | WI | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joyful Mind, LLC | Professional | Current |
Accepting new patients |
| Charis Counseling, LLC | Professional | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 5464-125 | WI | Yes |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 15875-132 | WI |
Addresses
Primary practice location
7387 Logerquist Rd
Baileys Harbor, WI 54202-9610
Mailing address
7387 Logerquist Rd
Baileys Harbor, WI 54202-9610
Phone (715) 451-7530
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15875-132 | Other | WI | STATE OF WISCONSIN LICENSE |
| 5464-125 | Other | WI | STATE OF WISCONSIN LICENSE |
Other providers in Baileys Harbor, WI
All providers in Baileys Harbor, WI · Professional Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.