Individual provider Active NPI

Courtney Pohlman, LMFT, PHD

  • Mental Health Counselor
  • Shiocton, WI
National Provider Identifier
1972028850
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
542-228 Issued in WI
Practice address
N5367 Mayflower Rd
Shiocton, WI 54170-8934
Phone
(920) 986-3003
Fax
(920) 986-3004
NPI assigned
Aug 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 542-228 WI Primary

Addresses

Primary practice location

N5367 Mayflower Rd
Shiocton, WI 54170-8934

Mailing address

N5367 Mayflower Rd
Shiocton, WI 54170-8934
Phone (920) 986-3003

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231221003751 WI Practitioner - Marriage and Family Therapist 5799135372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Counseling Center of the Fox Valley, Inc.Group PAC ID 9234034349, 11 clinicians

Practice addresses (Care Compare)

110 Church Ave
Oshkosh, WI 54901-4746
Phone 9208869319118

1205 Province Ter
Menasha, WI 54952-7017
Phone 9208869319118

510 Sullivan Ave
Kaukauna, WI 54130-2326
Phone 9208869319118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
542-228WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Counseling Center of the Fox Valley, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

110 Church Ave
Oshkosh, WI 54901
Phone (920) 235-1678

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1972028850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N5367 MAYFLOWER RD",
            "city": "SHIOCTON",
            "state": "WI",
            "postal_code": "541708934",
            "telephone_number": "920-986-3003",
            "fax_number": "920-986-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N5367 MAYFLOWER RD",
            "city": "SHIOCTON",
            "state": "WI",
            "postal_code": "541708934",
            "telephone_number": "920-986-3003",
            "fax_number": "920-986-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POHLMAN",
        "first_name": "COURTNEY",
        "name_prefix": "Dr.",
        "credential": "LMFT, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-11",
        "last_updated": "2024-04-05",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "542-228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shiocton, WI

Sources for this page

Verify at the official NPI Registry.