Individual provider Active NPI

Marcia Anne Catlett, LCPC, LPC, MA, MED

  • Professional Counselor
  • Palmyra, WI
National Provider Identifier
1053457044
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
125-3939 Issued in WI
Practice address
N158 Tamarack Rd
Palmyra, WI 53156-9789
Phone
(262) 745-0368
Fax
(262) 745-0368
NPI assigned
Jan 29, 2007
Last updated
Apr 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X 125-3939 WI Primary

Addresses

Primary practice location

N158 Tamarack Rd
Palmyra, WI 53156-9789

Mailing address

PO Box 732
Lake Geneva, WI 53147-0732
Phone (262) 745-0368

Other identifiers 1

IdentifierTypeStateIssuer
437-08-200MedicaidWI

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 Arts, Master of Education

State licenses

LicenseStateTypeSpecialty
125-3939WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kettle Moraine Behavioral Health Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1053457044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 732",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531470732",
            "telephone_number": "262-745-0368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N158 TAMARACK RD",
            "city": "PALMYRA",
            "state": "WI",
            "postal_code": "531569789",
            "telephone_number": "262-745-0368",
            "fax_number": "262-745-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CATLETT",
        "first_name": "MARCIA",
        "middle_name": "ANNE",
        "credential": "LCPC, LPC, MA, MED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "125-3939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "437-08-200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmyra, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.