Kayla Petersen, LPC in Rice Lake, WI - Medicare Counselor Provider

Kayla Petersen, LPC is a medicare enrolled "Counselor - Mental Health" provider in Rice Lake, Wisconsin. Her current practice location is 331 S Main St Ste H, Rice Lake, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (715) 236-8500.

Kayla Petersen is licensed to practice in Wisconsin (license number 10761) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1649921362.

Contact Information

	Kayla Petersen, LPC
	331 S Main St Ste H, Rice Lake, WI 54868-2253
	(715) 236-8500
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kayla Petersen
Gender	Female
Speciality	Counselor - Mental Health
Location	331 S Main St Ste H, Rice Lake, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1649921362
Provider Enumeration Date: 01/13/2022
Last Update Date: 06/25/2025

Medicare PECOS Information:

PECOS PAC ID: 9335599521
Enrollment ID: I20240101000117

Medical Identifiers

Medical identifiers for Kayla Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1649921362	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	5196226 (Wisconsin)	Secondary
101YM0800X	Counselor - Mental Health	10761 (Wisconsin)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kayla Petersen allows following entities to bill medicare on her behalf.

Entity Name	Aurora Counseling Centers Employee Support Systems Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437240868 PECOS PAC ID: 2264338391 Enrollment ID: O20031210000266

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kayla Petersen is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kayla Petersen, LPC Po Box 860912, Minneapolis, MN 55486-0912 Ph: (507) 284-2511	Kayla Petersen, LPC 331 S Main St Ste H, Rice Lake, WI 54868-2253 Ph: (715) 236-8500

Reviews and Comments

Counselor in Rice Lake, WI

Kristina Kay Olson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 138 N Main St # 230, Rice Lake, WI 54868 Phone: 715-246-4840
Mr. Chao Xiong, MS LPC Counselor Medicare: Medicare Enrolled Practice Location: 138 N Main St Ste 206, Rice Lake, WI 54868 Phone: 715-836-0064 Fax: 715-836-0065
Michelle Richardson, MS Counselor Medicare: Medicare Enrolled Practice Location: 312 W Knapp St Ste B, Rice Lake, WI 54868 Phone: 715-836-0064 Fax: 715-836-0065
Mrs. Grace E Branham, LMFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 1035 N Main St, Rice Lake, WI 54868 Phone: 715-234-4313
Joanne L Faltz Bailey, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 331 S Main St, Rice Lake, WI 54868 Phone: 715-236-8500
Amanda Koteras-piper, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2021 Cenex Dr Unit F, Rice Lake, WI 54868 Phone: 715-201-2578
Beverly A Haverly, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1035 N Main St, Rice Lake, WI 54868 Phone: 715-234-4313 Fax: 715-736-0194

Kayla Petersen, LPC - Medicare Counselor in Rice Lake, WI