Active NPI
Angela R Myhre, M.S., L.M.F.T.
- Marriage & Family Therapist
- Elm Grove, WI
National Provider Identifier
1114165693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 782-124
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 782-124 | WI | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tetzlaff & Myhre Psychotherapy and Assessments, LLC | Current | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Elm Grove, WI
- NPI 1477151439
-
- Clinical Social Worker
- Belleville, WI
- NPI 1659579928
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.