Individual provider Active NPI

Stefanie Carol Palmer, M.A., TLPC

  • Professional Counselor
  • Mequon, WI
National Provider Identifier
1295012805
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1050-226 Issued in WI
Practice address
10532 N Port Washington Rd
Ste 1B
Mequon, WI 53092-5563
Phone
(262) 242-3810
Fax
(262) 242-3816
NPI assigned
Nov 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1050-226 WI Primary

Addresses

Primary practice location

10532 N Port Washington Rd
Ste 1B
Mequon, WI 53092-5563

Mailing address

10532 N Port Washington Rd
Ste 1B
Mequon, WI 53092-5563
Phone (262) 242-3810

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1050-226WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Consulting of Kenosha LLC Past Accepting new patients

Organizations & group practices 1

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": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1295012805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10532 N PORT WASHINGTON RD",
            "address_2": "STE 1B",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925563",
            "telephone_number": "262-242-3810",
            "fax_number": "262-242-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10532 N PORT WASHINGTON RD",
            "address_2": "STE 1B",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925563",
            "telephone_number": "262-242-3810",
            "fax_number": "262-242-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "STEFANIE",
        "middle_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "M.A., TLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-10",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "1050-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.