Individual provider Active NPI

Tamara Marie Makhlouf, LPC

  • Social Worker
  • Milwaukee, WI
National Provider Identifier
1154356095
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
3333-125 Issued in WI
Practice address
9000 W Wisconsin Ave Ste 240
Milwaukee, WI 53226-4874
Phone
(414) 337-3400
Fax
(414) 337-3409
NPI assigned
Jul 11, 2006
Last updated
Dec 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3333125 WI
Social Worker 104100000X 3333-125 WI Primary

Addresses

Primary practice location

9000 W Wisconsin Ave Ste 240
Milwaukee, WI 53226-4874

Mailing address

9000 W Wisconsin Ave # Ms 958
Milwaukee, WI 53226-4874

Other identifiers 1

IdentifierTypeStateIssuer
1154356095MedicaidWI

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

LicenseStateTypeSpecialty
3333125WIMDProfessional Counselor
3333-125WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Medical Group, Inc Professional PastSince Dec 21, 2021 Accepting new patients
Children's Medical Group, Inc Professional PastSince Sep 1, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1154356095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE STE 240",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-337-3400",
            "fax_number": "414-337-3409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKHLOUF",
        "first_name": "TAMARA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3333125",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "3333-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154356095",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.