COLEEN RAE KITTLESON LPC NCC NPI 1073750295

NPI Information

NPI: 1073750295
Provider Name: COLEEN RAE KITTLESON, LPC, NCC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

PECOS Registration: Yes

Address:
12970 W BLUEMOUND RD
308
ELM GROVE, WI
ZIP 53122
Phone: (262) 780-1020
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Coleen Rae Kittleson, LPC, NCC is a professional counselor in Elm Grove, WI. Coleen Rae Kittleson, LPC, NCC NPI is 1073750295. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

12970 W BLUEMOUND RD
308
ELM GROVE, WI
ZIP 53122-607
Phone: (262) 780-1020
Fax: (262) 780-1022

The NPI 1073750295 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 1/9/2009 and was last updated on 2/5/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	1407-125	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	10001649	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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