Individual provider Active NPI

Angela R Myhre, M.S., L.M.F.T.

  • Marriage & Family Therapist
  • Elm Grove, WI
National Provider Identifier
1114165693
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
782-124 Issued in WI
Practice address
890 Elm Grove Rd Ste 203
Elm Grove, WI 53122-2528
Phone
(608) 669-6020
NPI assigned
Jan 22, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 782-124 WI Primary

Addresses

Primary practice location

890 Elm Grove Rd Ste 203
Elm Grove, WI 53122-2528

Mailing address

2421 Chalet Gardens CT
#3
Fitchburg, WI 53711-4491
Phone (608) 228-0589

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 Science

State licenses

LicenseStateTypeSpecialty
782-124WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tetzlaff & Myhre Psychotherapy and Assessments, LLC CurrentSince May 12, 2024 Accepting new patients
Foundations Counseling Center, Inc. Past Accepting new patients

Locations

890 Elm Grove Rd
Bldg 2
Elm Grove, WI 53122

890 Elm Grove Rd
Ste 203
Elm Grove, WI 53122
Phone (262) 719-2975

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1114165693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 CHALET GARDENS CT",
            "address_2": "#3",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537114491",
            "telephone_number": "608-228-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 ELM GROVE RD STE 203",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531222528",
            "telephone_number": "608-669-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYHRE",
        "first_name": "ANGELA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "M.S., L.M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-22",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "782-124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 8, 2024; 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.