NPIMap

Organization Active NPI

Healing Path Psychotherapy, LLC

  • Professional Counselor
  • Mequon, WI
National Provider Identifier
1124532783
Registry record updated Nov 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4182-125 Issued in WI
Legal business name
HEALING PATH PSYCHOTHERAPY, LLC
Practice address
10144 N Port Washington Rd Ste LL-C
Mequon, WI 53092-5796
Phone
(262) 292-1277
Fax
(262) 292-4077
NPI assigned
Nov 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2017

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

Authorized official

Name
Tricia DammNPI 1225540610
Title
Psychotherapist
Phone
(262) 292-1277

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 4182-125 WI Primary

Addresses

Primary practice location

10144 N Port Washington Rd Ste LL-C
Mequon, WI 53092-5796

Mailing address

11035 N Hedgewood LN
Mequon, WI 53092-4909
Phone (262) 292-1277

National Provider Directory

National Provider Directory

Locations

10144 N Port Washington Rd
Ste Llc
Mequon, WI 53092
Phone (262) 292-1277

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1510963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510963200000",
    "number": "1124532783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11035 N HEDGEWOOD LN",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530924909",
            "telephone_number": "262-292-1277",
            "fax_number": "262-292-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10144 N PORT WASHINGTON RD STE LL-C",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925796",
            "telephone_number": "262-292-1277",
            "fax_number": "262-292-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING PATH PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-18",
        "last_updated": "2017-11-18",
        "status": "A",
        "authorized_official_last_name": "DAMM",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "262-292-1277"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4182-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2017; 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.