Alisha Petrouske

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5232 Issued in WI

Practice address

123 N Oakland Ave
Green Bay, WI 54303-2831

Phone

(920) 770-4088

Fax

(651) 705-0026

NPI assigned

Feb 10, 2022

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Power for Change, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1124322284
  NPD

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1245984079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 N OAKLAND AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032831",
            "telephone_number": "920-770-4088",
            "fax_number": "651-705-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N OAKLAND AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032831",
            "telephone_number": "920-770-4088",
            "fax_number": "651-705-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROUSKE",
        "first_name": "ALISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Mary Peterson, OT
• Pebbles L Peterson, APSW
• Stephanie Marie Peterson, RN, BSN
• Tara Peterson, APNP
• Rylee M Petit, OT
• Eilis Petzke
• Nicholas Pflum
• Stephanie Philipp
• Abigail Phillips, NP-C
• Jacquelyn Renee Phillips, APNP

• Professional Counselor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.