Individual provider Active NPI

Jeesenia Zavala, QTT-LPC-IT

  • Professional Counselor
  • Milwaukee, WI
National Provider Identifier
1073234191
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5426-226 Issued in WI
Practice address
2906 S 20TH St
Milwaukee, WI 53215-3732
Phone
(414) 672-1353
Fax
(414) 385-7551
NPI assigned
Sep 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5426-226 WI
Professional Counselor 101YP2500X 5426-226 WI Primary

Addresses

Primary practice location

2906 S 20TH St
Milwaukee, WI 53215-3732

Mailing address

PO Box 778789
Chicago, IL 60677-8789
Phone (414) 672-1353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240717001706 WI Practitioner - Mental Health Counselor 9032654744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
University of Wisconsin School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4570 S 27TH St
Milwaukee, WI 53221-2145
Phone (414) 672-1353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5426-226WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sixteenth Street Community Health Centers, Inc. CurrentSince Jul 15, 2024 Accepting new patients
16TH Street Community Health Center Inc. Current Accepting new patients
Sixteenth Street Community Health Centers, Inc. CurrentSince Jul 15, 2024 Accepting new patients

Locations

1337 S Cesar E Chavez Dr
Milwaukee, WI 53204
Phone (414) 672-1354

4570 S 27th St
Milwaukee, WI 53221
Phone (414) 325-8720

1635 W National Ave
Milwaukee, WI 53204
Phone (262) 408-5094

1032 S Cesar E Chavez Dr
Milwaukee, WI 53204

2906 S 20th St
Milwaukee, WI 53215
Phone (414) 385-8800

309 E North St
Waukesha, WI 53188
Phone (262) 408-2530

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1073234191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 778789",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606778789",
            "telephone_number": "414-672-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 S 20TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532153732",
            "telephone_number": "414-672-1353",
            "fax_number": "414-385-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAVALA",
        "first_name": "JEESENIA",
        "credential": "QTT-LPC-IT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "5426-226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5426-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.