Individual provider Active NPI

Susanne D Wesle, LPC

  • Professional Counselor
  • Appleton, WI
National Provider Identifier
1174147664
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
10464 Issued in WI
Practice address
2500 E Enterprise Ave Ste B
Appleton, WI 54913-8556
Phone
(920) 416-8577
Fax
(608) 668-4006
NPI assigned
Jun 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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 4672226 WI
Professional Counselor 101YP2500X 10464 WI Primary

Addresses

Primary practice location

2500 E Enterprise Ave Ste B
Appleton, WI 54913-8556

Mailing address

1900 Silver Lake Rd NW Ste 110
New Brighton, MN 55112-1789
Phone (651) 628-9566

Other practice location 1

225 S Main St Suite 3
Seymour, WI 54165-1439
Phone (920) 385-1420

Other practice location 2

1011 N Lynndale Dr Ste 2D
Appleton, WI 54914-3091
Phone (920) 385-1420

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240221001888 WI Practitioner - Mental Health Counselor 9830533504 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

201 Main St
Suite 500
La Crosse, WI 54601-0716
Phone (608) 668-4005

2500 E Enterprise Ave
Suite B
Appleton, WI 54913-8556
Phone (920) 416-8577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4672226WIMDMental Health Counselor
10464WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Apr 8, 2024 Accepting new patients
Nystrom & Associates Counseling Wi., S.C. CurrentSince Apr 8, 2024 Accepting new patients
Integrity Counseling, LLC CurrentSince Jan 9, 2024 Accepting new patients

Locations

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

1011 N Lynndale Dr
Ste 2D
Appleton, WI 54914
Phone (920) 385-1420

2500 E Enterprise Ave
Ste B
Appleton, WI 54913
Phone (920) 416-8577

201 Main St
Ste 500
La Crosse, WI 54601
Phone (608) 668-4005

225 S Main St
Stop 3
Seymour, WI 54165
Phone (920) 385-1420

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1174147664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E ENTERPRISE AVE STE B",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138556",
            "telephone_number": "920-416-8577",
            "fax_number": "608-668-4006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 S Main St Suite 3",
            "address_purpose": "LOCATION",
            "city": "Seymour",
            "state": "WI",
            "postal_code": "541651439",
            "country_code": "US",
            "telephone_number": "920-385-1420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1011 N Lynndale Dr Ste 2D",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549143091",
            "country_code": "US",
            "telephone_number": "920-385-1420",
            "fax_number": "866-327-3295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WESLE",
        "first_name": "SUSANNE",
        "middle_name": "D",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-01",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "4672226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "10464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.