Mara L Youngbauer, LPCIT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1206226 Issued in WI

Practice address

2600 N Mayfair Rd
Suite 650
Wauwatosa, WI 53226-1309

Phone

(414) 771-9304

Fax

(414) 771-9543

NPI assigned

May 9, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Shore Counseling and Consulting Clinic, S.C.

  • Group Psychotherapy Psychologist
  • Milwaukee, WI
  • NPI 1588710073
  NPD (past)

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336521600000",
    "number": "1215296405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W151N8714 MARSHALL DR",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530513109",
            "telephone_number": "262-893-3615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 N MAYFAIR RD",
            "address_2": "SUITE 650",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261309",
            "telephone_number": "414-771-9304",
            "fax_number": "414-771-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNGBAUER",
        "first_name": "MARA",
        "middle_name": "L",
        "credential": "LPCIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-09",
        "last_updated": "2012-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "1206226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588710073",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bao Yang, MSW, LCSW
• Dalia Yehyawi, DDS
• Alexander Young, DC
• Debra Rena Young, LPN,CCMA, NA
• Karissa Young, LCSW
• Your First Choice Home Health Care Inc
• Mohammed Ibbad Yousuf, MD
• Xiaodan Lucy Yu, ACUPUNCTURIST
• Rebecca Danvers Yuan, NNP-BC, APNP
• Steven M. Zabel, P.A.

• Professional Counselor in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; 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.