Individual provider Active NPI

Autumn Verstegan Melian, LPC

  • Counselor
  • Elm Grove, WI
National Provider Identifier
1093373136
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
8147125 Issued in WI
Practice address
13000 W Bluemound Rd Ste 300
Elm Grove, WI 53122-2650
Phone
(262) 785-9188
NPI assigned
Jun 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Counselor 101Y00000X 8147125 WI Primary

Addresses

Primary practice location

13000 W Bluemound Rd Ste 300
Elm Grove, WI 53122-2650

Mailing address

13000 W Bluemound Rd Ste 300
Elm Grove, WI 53122-2650
Phone (262) 785-9188

Other practice location 1

2669 N Richards St
Milwaukee, WI 53212-2850
Phone (800) 438-1772

Other names 1

  • Mrs. Autumn Verstegan Ehlinger Former name

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

State licenses

LicenseStateTypeSpecialty
8147125WIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Elmbrook Family Counseling Center LLP CurrentSince Mar 28, 2021 Accepting new patients
Wisconsin Lutheran Child & Family Service Past Accepting new patients
Wisconsin Lutheran Child and Family Service Inc Professional Past Accepting new patients

Locations

13000 W Bluemound Rd
Ste 300
Elm Grove, WI 53122
Phone 2627859188 ext. 26278

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": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1093373136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 W BLUEMOUND RD STE 300",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222650",
            "telephone_number": "262-785-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 W BLUEMOUND RD STE 300",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222650",
            "telephone_number": "262-785-9188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2669 N Richards St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532122850",
            "country_code": "US",
            "telephone_number": "800-438-1772",
            "fax_number": "262-345-5562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MELIAN",
        "first_name": "AUTUMN",
        "middle_name": "VERSTEGAN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "8147125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUTUMN",
            "last_name": "EHLINGER",
            "middle_name": "VERSTEGAN",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elm Grove, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.