Brooke S Siddell

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

857124 Issued in WI

Practice address

3800 N Mayfair Rd
Wauwatosa, WI 53222-2213

Phone

(414) 536-8333

Fax

(414) 536-8348

NPI assigned

Nov 10, 2008

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

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

Specialty

Marriage and Family Therapist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lutheran Counseling and Family Services of Wisconsin IncGroup PAC ID 4587565742, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lutheran Counseling and Family Services of Wisconsin Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wauwatosa, WI
  • NPI 1184703290

  Marriage & Family Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1225282874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532222213",
            "telephone_number": "608-512-7668",
            "fax_number": "414-536-8348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532222213",
            "telephone_number": "414-536-8333",
            "fax_number": "414-536-8348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDELL",
        "first_name": "BROOKE",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-10",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "857124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirley Y Godiwalla M.D,S.C
• Yevgenia Shmelkova, D.O.
• Mohammad Shoiab, M.D.
• Jeffrey B. Shovers, M.D.
• Nancy Ellen Shumate, DDS
• Danish S Siddiqui, MD
• Mark Siegel, MD
• Mindas Siliunas, M.D.
• Silver Heart Community Services LLC
• Deidre Simms, RN

• Marriage & Family Therapist in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Marriage & Family Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.