Suzanne K Ronquillo, MA, LPC, LMFT-IT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

364-228 Issued in WI

Practice address

121 W Main St
Port Washington, WI 53074-1813

Phone

(262) 284-8200

Fax

(262) 284-8103

NPI assigned

Aug 21, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of OzaukeeGroup PAC ID 5698737450, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• County of Ozaukee

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Port Washington, WI
  • NPI 1609867001
  Medicare reassignment Care Compare group NPD
• County of Ozaukee

  • Public Health or Welfare Agency
  • Port Washington, WI
  • NPI 1740475250
  NPD

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719187200000",
    "number": "1306270756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 W HIGHLAND BLVD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532083252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W MAIN ST",
            "city": "PORT WASHINGTON",
            "state": "WI",
            "postal_code": "530741813",
            "telephone_number": "262-284-8200",
            "fax_number": "262-284-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RONQUILLO",
        "first_name": "SUZANNE",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC, LMFT-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-21",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5207-125",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "364-228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Prohuska, APSW
• Carol L Ramos, LPC
• Kim Marie Rasmussen, OTR
• Laurelle A Rathke, LPC
• David C. Reif, D.C.
• Michael Charles Ross, D.C.
• Michaela Rusch, LPC
• Lorinda Sadikovic, M.A.
• Debra Lynne Saltzman
• Richard A Schloegel, BSW

• Marriage & Family Therapist in Port Washington, WI
• Providers in Port Washington, 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 Jun 24, 2024; 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.