Susan M Mielke, D.MIN. LCPC (IL)

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.007045 Issued in IL

Practice address

307 Henry St
Suite 308
Alton, IL 62002-6326

Phone

(618) 474-7300

Fax

(618) 462-8146

NPI assigned

Mar 7, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320624000000",
    "number": "1114994340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 HENRY ST",
            "address_2": "SUITE 308",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026326",
            "telephone_number": "618-474-7300",
            "fax_number": "618-462-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 HENRY ST",
            "address_2": "SUITE 308",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026326",
            "telephone_number": "618-474-7300",
            "fax_number": "618-462-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIELKE",
        "first_name": "SUSAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.MIN. LCPC (IL)",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2011-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.007045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Alton, IL
• Providers in Alton, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; 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.