NPIMap

Organization Active NPI

Sebastian Family Psycholgy Practice

  • Professional Counselor
  • Glendale, WI
National Provider Identifier
1124441373
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1914-226 Issued in WI
Legal business name
SEBASTIAN FAMILY PSYCHOLGY PRACTICE
Practice address
6025 N Green Bay Ave
Glendale, WI 53209-3811
Phone
(414) 247-0801
Fax
(414) 247-0816
NPI assigned
Jan 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Authorized official

Name
Yvonne Ssempijja
Title
Director of Operations
Phone
(414) 247-0801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 1914-226 WI Primary

Addresses

Primary practice location

6025 N Green Bay Ave
Glendale, WI 53209-3811

Mailing address

1720 W Florist Ave Ste 125
Glendale, WI 53209-3862
Phone (414) 247-0801

National Provider Directory

National Provider Directory
Tax ID family
Sebastian Family Psycholgy Practice3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1720 W Florist Ave
Ste 125
Glendale, WI 53209
Phone (414) 247-0801

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1390435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1124441373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 W FLORIST AVE STE 125",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532093862",
            "telephone_number": "414-247-0801",
            "fax_number": "414-247-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 N GREEN BAY AVE",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532093811",
            "telephone_number": "414-247-0801",
            "fax_number": "414-247-0816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEBASTIAN FAMILY PSYCHOLGY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-23",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "SSEMPIJJA",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "414-247-0801"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "1914-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.