Individual provider Active NPI

Patricia Ann Desnoyers, LCSW

  • Mental Health Counselor
  • Madison, WI
National Provider Identifier
1063534477
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1487-123 Issued in WI
Practice address
310 N Midvale Blvd
Suite 202
Madison, WI 53705-3265
Phone
(608) 280-6496
Fax
(608) 238-1929
NPI assigned
Apr 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1487-123 WI Primary

Addresses

Primary practice location

310 N Midvale Blvd
Suite 202
Madison, WI 53705-3265

Mailing address

310 N Midvale Blvd
Suite 202
Madison, WI 53705-3265
Phone (608) 280-6496

Other identifiers 1

IdentifierTypeStateIssuer
43566100MedicaidWI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1487-123WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Psychology Clinic Inc. PastSince Mar 8, 2010 Accepting new patients
Christianson Pfau Chiropractic LLC Past Accepting new patients

Organizations & group practices 2

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063534477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N MIDVALE BLVD",
            "address_2": "SUITE 202",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053265",
            "telephone_number": "608-280-6496",
            "fax_number": "608-238-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N MIDVALE BLVD",
            "address_2": "SUITE 202",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053265",
            "telephone_number": "608-280-6496",
            "fax_number": "608-238-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESNOYERS",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "1487-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43566100",
            "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 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.

Verify at the official NPI Registry.