Active NPI
Nicholas Kavelaris, M.A.
- Professional Counselor
- Waukesha, WI
National Provider Identifier
1992180590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 5703 125
- Practice address
- 20700 Watertown Rd Ste 102
Waukesha, WI 53186-1800 - Phone
- (262) 782-1474
- NPI assigned
- Jul 23, 2015
- Sex
- Male
- 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 | 5703 125 | WI | Primary |
Addresses
Primary practice location
20700 Watertown Rd Ste 102
Waukesha, WI 53186-1800
Mailing address
20700 Watertown Rd Ste 102
Waukesha, WI 53186-1800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5703 125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Life Resources, Inc. | Professional | Past | Accepting new patients |
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": "1437609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437696000000",
"number": "1992180590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20700 WATERTOWN RD STE 102",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531861800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20700 WATERTOWN RD STE 102",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531861800",
"telephone_number": "262-782-1474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAVELARIS",
"first_name": "NICHOLAS",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-23",
"last_updated": "2015-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "5703 125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.