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KIM D PRUSHA LPC
NPI 1114223542
Counselor - Professional in Menasha, WI

Active since February 02, 2011PECOS EnrolledAccepts Medicare Assignment
1095 MIDWAY RD, MENASHA, WI 54952(920) 720-2300(920) 720-3806 Get Directions Write a Review

NPPES record last updated: December 8, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Kim D Prusha Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIM D PRUSHA LPC (NPI 1114223542) is an individual professional provider in Menasha, Wisconsin, licensed in Wisconsin (397) and active in the NPI registry since February 2011. She is enrolled in Medicare PECOS and is a graduate of Other (1990).

NPPES Registry Identity

NPI1114223542
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKIM D PRUSHACredential: LPC
Location Address1095 MIDWAY RDMenasha, WI 54952-1115
Mailing Address3 Neenah CtrNeenah, WI 54956-3070 · (920) 720-2300
Phone(920) 720-2300
Fax(920) 720-3806
Sole ProprietorNo
Medical School CMSOtherGraduated 1990
Enumeration DateFebruary 2, 2011
Last NPPES UpdateDecember 8, 2023
NPPES CertifiedDecember 8, 2023
✔ NPI 1114223542 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in WI · 397
1095 MIDWAY RD, Menasha, WI 54952
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kim D Prusha Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9739524935
PECOS Enrollment IDI20240227004184
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kim Prusha reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Thedacare, Incorporated
Same address
Counselor
1095 MIDWAY RD
Menasha, WI 54952
  • Reassigned Medicare billing, Wisconsin enrollment
  • 988 clinicians in this Medicare group
NPI 1306959515 (920) 720-2300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DARLENE LEARY
Counselor (Addiction (Substance Use Disorder))
1095 MIDWAY RD
MENASHA, WI 54952
Calumet County (920) 720-2300
YONG LI
Psychiatry & Neurology (Psychiatry)
1095 MIDWAY RD
MENASHA, WI 54952
Calumet County (920) 720-2300
LISA BREDAEL
Counselor
1095 MIDWAY RD
MENASHA, WI 54952
Calumet County (920) 720-2300
LYNNE DREWS
Counselor (Addiction (Substance Use Disorder))
1095 MIDWAY RD
MENASHA, WI 54952
Calumet County (920) 720-2300
YVETTE SAMANTHA GOEBEL PH.D
Psychologist (Clinical)
1095 MIDWAY RD
MENASHA, WI 54952
Calumet County (920) 720-3870
SAMANTHA JO PETERSEN APSW
Social Worker
1095 MIDWAY RD
MENASHA, WI 54952
Calumet County (920) 720-2300
SHAUNA S VANDEN HOOGEN SAC
Counselor (Addiction (Substance Use Disorder))
1095 MIDWAY RD
MENASHA, WI 54952
Calumet County (920) 720-3700
JILL M CISAR
Social Worker (Clinical)
1095 MIDWAY RD
MENASHA, WI 54952
Calumet County (920) 720-2300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kim Prusha's NPI number?

The NPI number for Kim Prusha is 1114223542. It was assigned to this individual provider in the NPPES registry on February 2, 2011.

Where is Kim Prusha located?

Kim Prusha practices at 1095 Midway Rd, Menasha, WI 54952. The listed phone number is (920) 720-2300.

What is Kim Prusha's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Kim Prusha enrolled in Medicare?

Yes. Kim Prusha is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kim Prusha's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kim Prusha reassigns Medicare benefits to Thedacare, Incorporated (Menasha, WI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kim Prusha's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kim Prusha accept?

Health plans from Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners, Network Health and Quartz and 1 other insurer list Kim Prusha as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kim Prusha was last updated on December 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.