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DR. HOLLY J WONDER LPC
NPI 1790063170
Counselor - Professional in Mequon, WI

Active since August 02, 2011PECOS EnrolledAccepts Medicare Assignment
11649 N PORT WASHINGTON RD STE 221, MEQUON, WI 53092(262) 912-1922 Get Directions Write a Review

NPPES record last updated: October 29, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 15, 2020, Feb 24, 2020 (2 updates tracked since 2020).

About Dr. Holly J Wonder Lpc NPPES

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

DR. HOLLY J WONDER LPC (NPI 1790063170) is an individual professional provider in Mequon, Wisconsin, licensed in Wisconsin (7697) and active in the NPI registry since August 2011. She is enrolled in Medicare PECOS, maintains a secondary practice location in Mequon, and is a graduate of Other (1985).

NPPES Registry Identity

NPI1790063170
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameDR. HOLLY J WONDERCredential: LPC
Location Address11649 N PORT WASHINGTON RD STE 221Mequon, WI 53092-3461
Mailing Address4800 N Scottsdale Rd Ste 2500Scottsdale, AZ 85251-7630 · (262) 912-1922
Phone(262) 912-1922
Sole ProprietorNo
Medical School CMSOtherGraduated 1985
Enumeration DateAugust 2, 2011
Last NPPES UpdateOctober 29, 20252 updates tracked since enumeration
NPPES CertifiedOctober 29, 2025
✔ NPI 1790063170 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 · 7697
11649 N PORT WASHINGTON RD STE 221, Mequon, WI 53092
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Secondary Practice Location 1

Location 111518 N Port Washington Rd Ste 202Mequon, WI 53092-3443 · Phone (262) 244-6177 · Fax (262) 299-3040

Other Identifiers 1

Medicaid100098109WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), HealthPartners and more.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

Dr. Holly J Wonder 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 ID7416441589
PECOS Enrollment IDI20251216002033
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 9

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

CASSANDRA A CARLSON LCSW
Social Worker (Clinical)
11649 N PORT WASHINGTON RD STE 221
MEQUON, WI 53092
Ozaukee County (262) 912-1922
TATYANA P SIMINAK APNP
Nurse Practitioner (Psychiatric/Mental Health)
11649 N PORT WASHINGTON RD STE 221
MEQUON, WI 53092
Ozaukee County (262) 912-1922
DANIEL P VOSS LPC
Counselor (Professional)
11649 N PORT WASHINGTON RD STE 221
MEQUON, WI 53092
Ozaukee County (262) 912-1922
EDUARD TSYRULNYKOV APNP
Nurse Practitioner (Psychiatric/Mental Health)
11649 N PORT WASHINGTON RD STE 221
MEQUON, WI 53092
Ozaukee County (262) 999-3495
MRS. SHAPARIS J JOHNSON LCSW
Social Worker (Clinical)
11649 N PORT WASHINGTON RD STE 221
MEQUON, WI 53092
Ozaukee County (262) 912-1922
MR. BRIAN SHAWN MARTINEZDELACOTERA LPC
Counselor (Professional)
11649 N PORT WASHINGTON RD STE 221
MEQUON, WI 53092
Ozaukee County (262) 912-1922
LISA ANN PARKER APNP
Nurse Practitioner (Psychiatric/Mental Health)
11649 N PORT WASHINGTON RD STE 221
MEQUON, WI 53092
Ozaukee County (262) 912-1922
CAROLYN J KLOTZ APNP
Nurse Practitioner (Psychiatric/Mental Health)
11649 N PORT WASHINGTON RD STE 221
MEQUON, WI 53092
Ozaukee County (262) 912-1922

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 Holly Wonder's NPI number?

The NPI number for Holly Wonder is 1790063170. It was assigned to this individual provider in the NPPES registry on August 2, 2011.

Where is Holly Wonder located?

Holly Wonder practices at 11649 N Port Washington Rd Ste 221, Mequon, WI 53092. The listed phone number is (262) 912-1922.

What is Holly Wonder's specialty?

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

Is Holly Wonder enrolled in Medicare?

Yes. Holly Wonder 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 Holly Wonder accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), HealthPartners, Medica and Network Health and 2 other insurers list Holly Wonder 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 Holly Wonder was last updated on October 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.