Active NPI
Alexander Waites, LPC-IT
- Professional Counselor
- Greenfield, WI
National Provider Identifier
1154094290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 10314-125
- Practice address
- 4811 S 76TH St # 305
Greenfield, WI 53220-4364 - Phone
- (414) 325-7741
- NPI assigned
- Jul 26, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 5032-226 | WI | |
| Professional Counselor | 101YP2500X | 10314-125 | WI | Primary |
Addresses
Primary practice location
4811 S 76TH St # 305
Greenfield, WI 53220-4364
Mailing address
4811 S 76TH St Ste 305
Greenfield, WI 53220-4364
Phone (414) 325-7741
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 |
|---|---|---|---|
| 5032-226 | WI | MD | Counselor |
| 10314-125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Child & Family Therapeutic Systems S.C. | Current | Accepting new patients |
Locations
4811 S 76th St
Ste 305
Milwaukee, WI 53220
Phone (414) 325-7741
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 and National Provider Directory roles.
-
- Clinical Social Worker
- Greenfield, WI
- NPI 1922176395
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678924800000",
"number": "1154094290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4811 S 76TH ST STE 305",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532204364",
"telephone_number": "414-325-7741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4811 S 76TH ST # 305",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532204364",
"telephone_number": "414-325-7741"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAITES",
"first_name": "ALEXANDER",
"credential": "LPC-IT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-26",
"last_updated": "2023-03-16",
"certification_date": "2023-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WI",
"license": "5032-226",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "10314-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.