Active NPI
Kelee Dangles, LCPC
- Professional Counselor
- Milwaukee, WI
National Provider Identifier
1164897435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6574-125
- Practice address
- 619 W Walnut St
Milwaukee, WI 53212-3839 - Phone
- (414) 810-3548
- Fax
- (414) 810-3590
- NPI assigned
- Dec 11, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 6574-125 | WI | Primary |
Addresses
Primary practice location
619 W Walnut St
Milwaukee, WI 53212-3839
Mailing address
9000 W Wisconsin Ave # Ms 958
Milwaukee, WI 53226-4874
Phone (414) 266-7615
Other practice location 1
4055 W Peterson Ave
Suite 202
Chicago, IL 60646-6182
Phone (773) 774-4447
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164897435 | Medicaid | WI |
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 |
|---|---|---|---|
| 6574-125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zeni Therapy, LLC | Professional | Current | Accepting new patients |
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.
-
- Professional Counselor
- Grafton, WI
- NPI 1255123535
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506988800000",
"number": "1164897435",
"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",
"telephone_number": "414-266-7615",
"fax_number": "414-236-6238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 W WALNUT ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532123839",
"telephone_number": "414-810-3548",
"fax_number": "414-810-3590"
}
],
"practiceLocations": [
{
"address_1": "4055 W Peterson Ave",
"address_2": "Suite 202",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606466182",
"country_code": "US",
"telephone_number": "773-774-4447",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DANGLES",
"first_name": "KELEE",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-11",
"last_updated": "2017-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "6574-125",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1164897435",
"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 Oct 3, 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.