Active NPI
Judson Chubbuck, LPC
- Professional Counselor
- Brookfield, WI
National Provider Identifier
1245393388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3233125
- Practice address
- 16535 W Bluemound Rd
Suite 200
Brookfield, WI 53005-5936 - Phone
- (262) 789-1191
- Fax
- (262) 821-6180
- NPI assigned
- Dec 19, 2006
- Last updated
- Feb 5, 2009
- Sex
- Male
- 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 | 3233125 | WI | Primary |
Addresses
Primary practice location
16535 W Bluemound Rd
Suite 200
Brookfield, WI 53005-5936
Mailing address
4928 W Wisconsin Ave
Milwaukee, WI 53208-3052
Phone (414) 774-1052
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40963300 | 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 |
|---|---|---|---|
| 3233125 | WI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233792000000",
"number": "1245393388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4928 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532083052",
"telephone_number": "414-774-1052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16535 W BLUEMOUND RD",
"address_2": "SUITE 200",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530055936",
"telephone_number": "262-789-1191",
"fax_number": "262-821-6180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUBBUCK",
"first_name": "JUDSON",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2009-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "3233125",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40963300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, WI
- Christian Life Counseling LLC (Christian Life Counseling)
- Christiansen Chiropractic, S.C.
- Matthew Christiansen
- Anna Marie Christopherson
- Nathan Christopherson, PT
- Albert Cimperman Jr., L.C.S.W.
- City of Brookfield (City of Brookfield Paramedics)
- Clarity Eyecare 920, SC
- Douglas Owen Clark, MD
- Jena Leigh Clark, OTR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.