Individual provider Active NPI

Michelle Gauger, MSE, LPC, SAC

  • Addiction (Substance Use Disorder) Counselor
  • Green Bay, WI
National Provider Identifier
1154606317
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
15830-132 Issued in WI
Practice address
300 Crooks St
Green Bay, WI 54301-4527
Phone
(920) 436-6800
Fax
(920) 432-5966
NPI assigned
Oct 19, 2011
Last updated
Feb 11, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 5114-125 WI
Addiction (Substance Use Disorder) Counselor 101YA0400X 15830-132 WI Primary

Addresses

Primary practice location

300 Crooks St
Green Bay, WI 54301-4527

Mailing address

300 Crooks St
Green Bay, WI 54301-4527
Phone (920) 436-6800

Other identifiers 3

IdentifierTypeStateIssuer
1154606317MedicaidWI
5114-125OtherWIWISCONSIN DEPT OF SAFETY AND PROFESSIONAL SERVICES
15830-132OtherWIWISCONSIN DEPT OF SAFETY AND PROFESSIONAL SERVICES

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
15830-132WIMDAddiction (Substance Use Disorder) Counselor
5114-125WIMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1154606317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CROOKS ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014527",
            "telephone_number": "920-436-6800",
            "fax_number": "920-432-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CROOKS ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014527",
            "telephone_number": "920-436-6800",
            "fax_number": "920-432-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUGER",
        "first_name": "MICHELLE",
        "credential": "MSE, LPC, SAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-19",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "5114-125",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15830-132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154606317",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN DEPT OF SAFETY AND PROFESSIONAL SERVICES",
            "identifier": "5114-125",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN DEPT OF SAFETY AND PROFESSIONAL SERVICES",
            "identifier": "15830-132",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.