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MS. KIMBERLY SUE WASOSKI LMHC, LCAC
NPI 1639358161
Counselor - Mental Health in South Bend, IN

Active since November 01, 2007PECOS EnrolledAccepts Medicare Assignment
3220 E JEFFERSON BLVD, SOUTH BEND, IN 46615(574) 222-2466(574) 222-2468 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Jul 12, 2017 (2 updates tracked since 2017).

About Ms. Kimberly Sue Wasoski Lmhc, Lcac NPPES

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

MS. KIMBERLY SUE WASOSKI LMHC, LCAC (NPI 1639358161) is an individual mental health provider in South Bend, Indiana, licensed in Indiana (39000873A) and active in the NPI registry since November 2007. She is enrolled in Medicare PECOS and is a graduate of Other (1988).

NPPES Registry Identity

NPI1639358161
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMS. KIMBERLY SUE WASOSKICredential: LMHC, LCAC
Location Address3220 E JEFFERSON BLVDSouth Bend, IN 46615-3028
Mailing Address3220 E. Jefferson Blvd.South Bend, IN 46615-2733 · (574) 222-2466 · Fax (574) 222-2468
Phone(574) 222-2466
Fax(574) 222-2468
Sole ProprietorNo
Medical School CMSOtherGraduated 1988
Enumeration DateNovember 1, 2007
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1639358161 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in IN · 39000873A
3220 E JEFFERSON BLVD, South Bend, IN 46615
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Other Identifiers 3

Other000000542441IN · Anthem
Medicaid200375890AIN
Other000000542441IN · Unicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Kimberly Sue Wasoski Lmhc, Lcac 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 ID3870896541
PECOS Enrollment IDI20240221003508
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.

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.

ERIN CLAIRE LARKIN
Counselor (Mental Health)
3220 E JEFFERSON BLVD
SOUTH BEND, IN 46615
St. Joseph County (574) 222-2468
AMI DANIELLE FAIR
Counselor (Mental Health)
3220 E JEFFERSON BLVD
SOUTH BEND, IN 46615
St. Joseph County (574) 222-2466
MARY POTTENGER
Counselor (Mental Health)
3220 E JEFFERSON BLVD
SOUTH BEND, IN 46615
St. Joseph County (765) 480-1180
SHAYNNA HOLLOWELL-WILLIAMS
Marriage & Family Therapist
3220 E JEFFERSON BLVD
SOUTH BEND, IN 46615
St. Joseph County (574) 222-2466
AUTUMN KUESPERT CTRS
Social Worker
3220 E JEFFERSON BLVD
SOUTH BEND, IN 46615
St. Joseph County (574) 222-2466
ABIGAIL STERLING POLLYEA
Counselor (Mental Health)
3220 E JEFFERSON BLVD
SOUTH BEND, IN 46615
St. Joseph County (574) 222-2466
DR. HEATHER HOLLEMAN PH.D., HSPP
Psychologist (Clinical)
3220 E JEFFERSON BLVD
SOUTH BEND, IN 46615
St. Joseph County (574) 339-4832
MARY LOVE
Counselor (Mental Health)
3220 E JEFFERSON BLVD
SOUTH BEND, IN 46615
St. Joseph County (574) 222-2466

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 Kimberly Wasoski's NPI number?

The NPI number for Kimberly Wasoski is 1639358161. It was assigned to this individual provider in the NPPES registry on November 1, 2007.

Where is Kimberly Wasoski located?

Kimberly Wasoski practices at 3220 E Jefferson Blvd, South Bend, IN 46615. The listed phone number is (574) 222-2466.

What is Kimberly Wasoski's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Kimberly Wasoski enrolled in Medicare?

Yes. Kimberly Wasoski 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.

What insurance does Kimberly Wasoski accept?

Health plans from Providence Health Plan list Kimberly Wasoski 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 Kimberly Wasoski was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.