Active NPI
Alexandra Devine Yarmulnik, LPC
- Professional Counselor
- Glendale, WI
National Provider Identifier
1124689146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4377226
- Practice address
- 6213 N Green Bay Ave
Glendale, WI 53209-3823 - Phone
- (414) 235-7443
- NPI assigned
- Jun 21, 2019
- Last updated
- Nov 7, 2025
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4377226 | WI | Primary |
Addresses
Primary practice location
6213 N Green Bay Ave
Glendale, WI 53209-3823
Mailing address
5726 S 113TH St
Hales Corners, WI 53130-1806
Phone (414) 791-3130
Other practice location 1
1429 N Prospect Ave
Milwaukee, WI 53202-3017
Phone (414) 235-7443
Other names 1
- Alexandra Devine
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4377226 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Embody Therapy LLC | Current | Accepting new patients |
Locations
6213 N Green Bay Ave
Glendale, WI 53209
Phone (414) 235-7443
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Shoreside Therapies Glendale
- Mental Health Counselor
- Glendale, WI
- NPI 1962371575
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762473600000",
"number": "1124689146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5726 S 113TH ST",
"city": "HALES CORNERS",
"state": "WI",
"postal_code": "531301806",
"telephone_number": "414-791-3130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6213 N GREEN BAY AVE",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532093823",
"telephone_number": "414-235-7443"
}
],
"practiceLocations": [
{
"address_1": "1429 N Prospect Ave",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532023017",
"country_code": "US",
"telephone_number": "414-235-7443",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YARMULNIK",
"first_name": "ALEXANDRA",
"middle_name": "DEVINE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-21",
"last_updated": "2025-11-07",
"certification_date": "2025-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "4377226",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ALEXANDRA",
"last_name": "DEVINE",
"credential": "LPC",
"code": "1",
"type": "Former Name"
}
]
}
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 Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.