CASSANDRA GILLEN (LPC) – Professional Counselor, NPI 1245058130

CASSANDRA GILLEN (LPC) is a healthcare provider. based in Kenosha, Wisconsin. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. 11254-125 (WI). The NPI Number for CASSANDRA GILLEN (LPC) is 1245058130

Main info

Female
4 Years Of Experience
Name
CASSANDRA GILLEN (LPC)
NPI
1245058130
Phone
(262) 488-3265
Address
4536 22ND AVE
Enumeration Date
30 September 2024
Last Update Date
30 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2626560044
Graduation Year
2022 (4 years ago)
PAC ID
1052844867
Group Practice PAC ID
0941195168
Professional Enrollment ID
I20241101000248
Address ID
WI531405917KE4536XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

1,748 MENTAL HEALTH COUNSELOR in WI

Provider Addresses for CASSANDRA GILLEN (LPC)

  • 4536 22ND AVE

    KENOSHA, WI 531405917

    Phone: (262) 488-3265

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-11-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241101000248IMental Health CounselorWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 53140)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941195168View full group profile
NameSpecialtyState
Cardiovascular Disease (Cardiology)IL
Clinical Social WorkerWI
Nurse PractitionerWI
Emergency MedicineWI
Clinical Social WorkerIL
-WI
Nurse PractitionerWI
P S Y C H I A T R YWI
Nurse PractitionerWI
Nurse PractitionerWI

Reviews

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Frequently asked questions

Can I use this page to confirm CASSANDRA GILLEN (LPC)'s NPI?
Yes. CASSANDRA GILLEN (LPC) is listed with NPI 1245058130 in the public NPI dataset.
Is CASSANDRA GILLEN (LPC) listed as active for patients and plans?
The listing shows CASSANDRA GILLEN (LPC) as active in the NPI system.
What taxonomy line describes CASSANDRA GILLEN (LPC)?
For research purposes, treat CASSANDRA GILLEN (LPC) as Professional Counselor in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for CASSANDRA GILLEN (LPC)?
CASSANDRA GILLEN (LPC)'s geographic hint is Kenosha, Wisconsin in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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