KAYLA PETERSEN (LPC) – Mental Health Counselor, NPI 1649921362

KAYLA PETERSEN (LPC) is a healthcare provider. based in Cameron, Wisconsin. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. 5196226 (WI). The NPI Number for KAYLA PETERSEN (LPC) is 1649921362

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
KAYLA PETERSEN (LPC)
NPI
1649921362
Phone
(715) 651-1638
Address
1097 25 1/8 ST
Enumeration Date
13 January 2022
Last Update Date
25 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7152354696
Graduation Year
2021 (5 years ago)
PAC ID
9335599521
Group Practice PAC ID
2264338391
Professional Enrollment ID
I20240101000117
Address ID
WI547512768ME406XXEXXX401

Contacts

Secure Messaging
kpetersen375221@ewd.direct.hshs.org
Secure Messaging
kpetersen2532926@ehrdirect.mayoclinicmsg.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness95
Years active:4State licenses:2Other names

1,748 MENTAL HEALTH COUNSELOR in WI

Provider Addresses for KAYLA PETERSEN (LPC)

  • 1097 25 1/8 ST

    CAMERON, WI 548229600

    Phone: (715) 651-1638

    Type: Mailing

  • 3410 OAKWOOD MALL DR STE 700

    EAU CLAIRE, WI 547012617

    Phone: (715) 832-1678

    Type: Location

  • 1101 Lake Ave W

    Ladysmith, WI 548481062

    Phone: (920) 496-4700

    Type: Location

  • 715 Decorah Rd

    West Bend, WI 530958112

    Phone: (715) 651-1368

    Type: Location

  • PO BOX 860912

    MINNEAPOLIS, MN 554860912

    Phone: (507) 284-2511

    Type: Mailing

  • 331 S MAIN ST STE H

    RICE LAKE, WI 548682253

    Phone: (715) 236-8500

    Type: Location

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: 2024-01-01

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
I20240101000117IMental 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 54822)

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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: 2264338391View full group profile
NameSpecialtyState
Clinical Social WorkerWI
Nurse PractitionerMI
Mental Health CounselorWI
P S Y C H I A T R YTN
Clinical Social WorkerWI
Mental Health CounselorWI

Reviews

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Frequently asked questions

What federal number belongs to KAYLA PETERSEN (LPC)?
The federal identifier for KAYLA PETERSEN (LPC) is NPI 1649921362.
Is KAYLA PETERSEN (LPC) currently active in the NPI registry?
CMS-published data lists KAYLA PETERSEN (LPC) as an active registrant.
What kind of provider is KAYLA PETERSEN (LPC)?
The page reflects Mental Health Counselor for KAYLA PETERSEN (LPC). Clinical services aligned with this taxonomy classification.
What location metadata exists for KAYLA PETERSEN (LPC)?
The page summarizes Cameron, Wisconsin for KAYLA PETERSEN (LPC); expand the address list for detail.
What if Cameron, Wisconsin seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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