KELLY THOMACK
NPI 1750796488
Counselor - Professional in Appleton, WI

NPI Status: Active since June 20, 2014

Contact Information

5471 W WATERFORD LN
APPLETON, WI
ZIP 54913
Phone: (920) 731-7445
Fax: (920) 731-7490

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  • Individual
  • Female
  • Counselor
  • Professional
  • Accepts Insurance

About KELLY THOMACK

This page provides the complete NPI Profile along with additional information for Kelly Thomack, a provider established in Appleton, Wisconsin with a medical specialization in Counselor, focusing in professional . The healthcare provider is registered in the NPI registry with number 1750796488 assigned on June 2014. The practitioner's primary taxonomy code is 101YP2500X with license number 5455-125 (WI). The provider is registered as an individual and her NPI record was last updated 4 years ago.

NPI
1750796488
Provider Name
KELLY THOMACK
Gender
Female
Entity Type
Individual
Location Address
5471 W WATERFORD LN APPLETON, WI 54913
Location Phone
(920) 731-7445
Location Fax
(920) 731-7490
Mailing Address
1835 E EDGEWOOD DR STE 105-540 APPLETON, WI 54913
Mailing Phone
(920) 731-7445
Mailing Fax
(920) 731-7490
Is Sole Proprietor?
No
Enumeration Date
06-20-2014
Last Update Date
07-15-2022
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Counselor Professional

Taxonomy Code
101YP2500X
Type
Behavioral Health & Social Service Providers
License No.
5455-125
License State
WI

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
  • Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • BridgeSpan Standard Bronze Plan - HMO
  • BridgeSpan Standard Gold Plan - HMO
  • BridgeSpan Standard Silver Plan - HMO
  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
  • CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
  • CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
  • CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - EPO
  • CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Gold Standard $2000 - EPO
  • CareSource (Common Ground Healthcare) Gold Standard $2000 - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - EPO
  • CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - Vision Exam - EPO
  • CareSource (Common Ground Healthcare) Silver Standard $6000 - EPO
  • CareSource (Common Ground Healthcare) Silver Standard $6000 - Vision Exam - EPO
  • Atlas $1,300 Gold - PPO
  • Atlas $2,000 Standard Gold - PPO
  • Atlas $3,050 Plus Silver - PPO
  • Atlas $3,800 HSA Silver - PPO
  • Atlas $6,000 Standard Silver - PPO
  • Atlas $6,800 Plus Bronze HSA - PPO
  • Atlas $7,500 Standard Bronze HSA - PPO
  • Atlas $8,400 HSA Bronze - PPO
  • NE WI Select $3,150 Plus Silver - PPO
  • NE WI Select $3,800 HSA Silver - PPO
  • NE WI Select $6,000 Standard Silver - PPO
  • NE WI Select $6,800 Plus Bronze HSA - PPO
  • NE WI Select $7,500 Standard Bronze HSA - PPO
  • NE WI Select $8,400 HSA Bronze - PPO
  • Oak $1,300 Gold - PPO
  • Oak $2,000 Standard Gold - PPO
  • Engage by Medica Bronze HSA - EPO
  • Engage by Medica Bronze Share - EPO
  • Engage by Medica Expanded Bronze Standard - EPO
  • Engage by Medica Gold $0 Copay PCP Visits - EPO
  • Engage by Medica Gold Share - EPO
  • Engage by Medica Gold Standard - EPO
  • Engage by Medica Silver $0 Copay PCP Visits - EPO
  • Engage by Medica Silver Share - EPO
  • Engage by Medica Silver Standard - EPO
  • Essentia Choice Care with Medica Bronze HSA - EPO
  • Essentia Choice Care with Medica Bronze Share - EPO
  • Essentia Choice Care with Medica Expanded Bronze Standard - EPO
  • Essentia Choice Care with Medica Gold $0 Copay PCP Visits - EPO
  • Essentia Choice Care with Medica Gold Share - EPO
  • Essentia Choice Care with Medica Gold Standard - EPO
  • Essentia Choice Care with Medica Silver $0 Copay PCP Visits - EPO
  • Essentia Choice Care with Medica Silver Share - EPO
  • Essentia Choice Care with Medica Silver Standard - EPO
  • Medica Individual Choice Bronze HSA - EPO
  • Medica Individual Choice Bronze Share - EPO
  • Prestige Bronze $0 Medical Deductible - HMO
  • Prestige Bronze $0 Medical Deductible + Dental + Vision - HMO
  • Prestige Bronze $0 Medical Deductible + Dental +Vision - HMO
  • Prestige Bronze Essential + 3 Free PCP Visits - HMO
  • Prestige Bronze Essential + Dental + Vision + 3 Free PCP Visits - HMO
  • Prestige Bronze Plus - HMO
  • Prestige Gold - HMO
  • Prestige Gold 50 + 1 Free PCP Visit - HMO
  • Prestige Gold 50 + Dental + Vision + 1 Free PCP Visit - HMO
  • Prestige Gold 50 + Dental + Vision+ 1 Free PCP Visit - HMO
  • Prestige Gold Essential + 3Free PCP Visits - HMO
  • Prestige Gold Essential + Dental + Vision + 3 Free PCP Visits - HMO
  • Prestige Silver - HMO
  • Prestige Silver Essential + 3 Free PCP Visits - HMO
  • Prestige Silver Essential + Dental + Vision + 3 Free PCP Visits - HMO
  • Bronze Classic 4700 - HMO
  • Bronze Classic 4700 | with AdventHealth - HMO
  • Bronze Classic Standard - HMO
  • Bronze Classic Standard | with AdventHealth - HMO
  • Bronze Elite + PCP Saver Plus - HMO
  • Bronze Elite + PCP Saver Plus | with AdventHealth - HMO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
  • Bronze Simple Chronic Care CKM - HMO
  • Bronze Simple Diabetes - HMO
  • Gold Classic Standard - HMO
  • Gold Classic Standard | with AdventHealth - HMO
  • Gold Elite Saver Plus | with AdventHealth - HMO
  • Gold Simple - HMO
  • Gold Simple | with AdventHealth - HMO
  • Silver Classic Standard - HMO
  • Silver Classic Standard | with AdventHealth - HMO
  • Silver Elite - HMO
  • Silver Elite | with AdventHealth - HMO
  • Silver Simple Breathe Easy with Enhanced COPD Benefits - HMO
  • Silver Simple Chronic Care CKM - HMO
  • Bronze Classic - EPO
  • Bronze Classic | with Bryan Health - EPO
  • Bronze Classic Standard - EPO
  • Bronze Classic Standard | with Bryan Health - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Bronze Elite + PCP Saver Plus | with Bryan Health - EPO
  • Bronze Simple Diabetes - EPO
  • Bronze Simple Diabetes | with Bryan Health - EPO
  • Gold Classic Standard - EPO
  • Gold Classic Standard | with Bryan Health - EPO
  • Gold Elite - EPO
  • Gold Elite | with Bryan Health - EPO
  • Silver Classic Standard - EPO
  • Silver Classic Standard | with Bryan Health - EPO
  • Silver Simple Diabetes - EPO
  • Silver Simple Diabetes | with Bryan Health - EPO
  • Silver Simple PCP Saver - EPO
  • Silver Simple PCP Saver | with Bryan Health - EPO
  • Silver Simple Women's Health with Menopause Benefits - EPO
  • Silver Simple Women's Health with Menopause Benefits | with Bryan Health - EPO
  • Connect 1500 Gold - EPO
  • Connect 6000 Silver - EPO
  • Connect 9800 Bronze - EPO
  • HSA Qualified 7500 Bronze - Choice Network - EPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO
  • Providence Oregon Standard Silver Plan - Signature Network - EPO
  • Bronze 8000 - EPO
  • Bronze Essential 9000 Deductible With 4 Copay No Deductible Office Visits - EPO
  • Bronze HSA 7000 - EPO
  • Gold 2300 - EPO
  • Regence Standard Bronze 7500 - EPO
  • Regence Standard Gold 2000 - EPO
  • Regence Standard Silver 6000 - EPO
  • Silver 6500 - EPO
  • Premier $2,000 - 25% - HMO
  • Premier $3,500 - 30% - HMO
  • Premier $4,000 - 50% - HMO
  • Premier $5,000 HDHP - HMO
  • Premier $6,000 - 40% - HMO
  • Premier $7,500 - HMO
  • Premier $7,500 HDHP - HMO
  • Premier HMO $1,500 - 30% - HMO
  • Premier HMO $2,500 - 20% Copay - HMO
  • Premier HMO $3,400 - 30% HDHP - HMO
  • Premier HMO $3,500 - 30% - HMO
  • Premier HMO $3,500 HDHP - HMO
  • Premier HMO $4,000 - 20% HDHP - HMO
  • Premier HMO $5,000 - 20% HDHP - HMO
  • Premier HMO $5,500 - 40% Copay - HMO
  • Premier HMO $7,500 HDHP - HMO
  • Premier HMO $750 - 10% - HMO
  • Premier HMO $9,500 - HMO
  • Premier POS $1,500 - 30% - POS
  • Premier POS $2,500 - 20% Copay - POS
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Essential- ($0 Virtual Urgent Care) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Standard - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Bronze Standard+ (Dental + Vision) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $5 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Standard - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx) - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1750796488, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
0
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
9
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
4
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 7 → 14 → 5 6 → 12 → 3 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 0 + 0 + 1 + 4 + 9 + 1 + 2 + 4 + 1 + 6 + 24 = 62

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1750796488.

Other Providers at the Same Location


The following 12 providers are registered at the same or a nearby location.

Radiology (Body Imaging)
5471 W WATERFORD LN
APPLETON, WI 54913
Family Medicine
5471 W WATERFORD LN
APPLETON, WI 54913
Family Medicine
5471 W WATERFORD LN
APPLETON, WI 54913
Nurse Practitioner
5471 W WATERFORD LN
APPLETON, WI 54913
Psychologist (Clinical)
5471 W WATERFORD LN
APPLETON, WI 54913
Social Worker (Clinical)
5471 W WATERFORD LN
APPLETON, WI 54913
Nurse Practitioner (Family)
5471 W WATERFORD LN
APPLETON, WI 54913
Nurse Practitioner
5471 W WATERFORD LN
APPLETON, WI 54913
Clinic/Center (Federally Qualified Health Center (FQHC))
5471 W WATERFORD LN
APPLETON, WI 54913
Registered Nurse (Addiction (Substance Use Disorder))
5471 W WATERFORD LN
APPLETON, WI 54913
Nurse Practitioner (Psychiatric/Mental Health)
5471 W WATERFORD LN
APPLETON, WI 54913
Nurse Practitioner
5471 W WATERFORD LN
APPLETON, WI 54913

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1750796488, enumerated as an "individual" on June 20, 2014.

The provider is located at 5471 W WATERFORD LN APPLETON, WI 54913 and the phone number is (920) 731-7445.

Counselor with taxonomy code 101YP2500X and a focus in Professional.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, BridgeSpan. Please consult your insurance carrier or call the provider to verify.