NPIMap

Organization Active NPI

212 Psychotherapy LLC

  • Professional Counselor
  • Madison, WI
National Provider Identifier
1053941666
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
212 PSYCHOTHERAPY LLC
Practice address
7109 Brindley Cir
Madison, WI 53719-2128
Phone
(608) 205-8650
NPI assigned
Jan 22, 2020
Last updated
May 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Authorized official

Name
Tanya KC Hiser, LPCNPI 1023266194
Title
Owner
Phone
(608) 516-4347

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
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

7109 Brindley Cir
Madison, WI 53719-2128

Mailing address

7109 Brindley Cir
Madison, WI 53719-2128
Phone (608) 516-4347

Other identifiers 2

IdentifierTypeStateIssuer
100098189MedicaidWI
43741200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210420002439 WI Part B Supplier - Clinic/Group Practice 9234547829 Receives reassigned benefits from 5 practitioners
Practice locations: Madison, WI

National Provider Directory

National Provider Directory

Locations

437 S Yellowstone Dr
Madison, WI 53719
Phone (608) 516-1734

437 S Yellowstone Dr
Ste 220
Madison, WI 53719
Phone (608) 516-4347

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1053941666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7109 BRINDLEY CIR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537192128",
            "telephone_number": "608-516-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7109 BRINDLEY CIR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537192128",
            "telephone_number": "608-205-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "212 PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-22",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A",
        "authorized_official_last_name": "HISER",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "KC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "608-516-4347",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100098189",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43741200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.