NPIMap

Organization Active NPI

Community Counseling Center of Madison, Wi, Inc.

  • Mental Health Counselor
  • Middleton, WI
National Provider Identifier
1003936899
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1222 Issued in WI
Legal business name
COMMUNITY COUNSELING CENTER OF MADISON, WI, INC.
Practice address
6629 University Ave
Suite 209
Middleton, WI 53562-3037
Phone
(608) 833-5880
Fax
(608) 829-3787
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Sharon A Barger, PH.D.NPI 1326179771
Title
Director
Phone
(608) 833-5880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 1222 WI Primary

Addresses

Primary practice location

6629 University Ave
Suite 209
Middleton, WI 53562-3037

Mailing address

6629 University Ave
Suite 209
Middleton, WI 53562-3037
Phone (608) 833-5880

Other identifiers 1

IdentifierTypeStateIssuer
42165100MedicaidWI

National Provider Directory

National Provider Directory

Locations

6629 University Ave
Ste 209
Middleton, WI 53562
Phone (608) 833-5880

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003936899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6629 UNIVERSITY AVE",
            "address_2": "SUITE 209",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623037",
            "telephone_number": "608-833-5880",
            "fax_number": "608-829-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6629 UNIVERSITY AVE",
            "address_2": "SUITE 209",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623037",
            "telephone_number": "608-833-5880",
            "fax_number": "608-829-3787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COUNSELING CENTER OF MADISON, WI, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARGER",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "608-833-5880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "1222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42165100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.