Active NPI
Wilma J Wernick, MS
- Art Therapist
- Brown Deer, WI
National Provider Identifier
1053410456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Art Therapist
- License
- 24036
- Practice address
- 3900 W Brown Deer Rd
Suite 200
Brown Deer, WI 53209 - Phone
- (414) 540-2170
- Fax
- (414) 540-2171
- NPI assigned
- Sep 22, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Art Therapist | 221700000X | 24036 | WI | Primary |
Addresses
Primary practice location
3900 W Brown Deer Rd
Suite 200
Brown Deer, WI 53209
Mailing address
3900 W Brown Deer Rd
Suite 200
Brown Deer, WI 53209
Phone (414) 540-2170
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24036 | Other | WI | LICENSED ART PSYCHOTHERAP |
| 43573400 | Medicaid | WI | |
| 98107 | Other | NATL ART THEARY CREDENTIA |
Other names 1
- Wilma J Ebert
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24036 | WI | MD | Art Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053410456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3900 W BROWN DEER RD",
"address_2": "SUITE 200",
"city": "BROWN DEER",
"state": "WI",
"postal_code": "53209",
"telephone_number": "414-540-2170",
"fax_number": "414-540-2171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 W BROWN DEER RD",
"address_2": "SUITE 200",
"city": "BROWN DEER",
"state": "WI",
"postal_code": "53209",
"telephone_number": "414-540-2170",
"fax_number": "414-540-2171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WERNICK",
"first_name": "WILMA",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": "WI",
"license": "24036",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED ART PSYCHOTHERAP",
"identifier": "24036",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43573400",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATL ART THEARY CREDENTIA",
"identifier": "98107",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "WILMA",
"last_name": "EBERT",
"middle_name": "J",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Brown Deer, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.