Individual provider Active NPI

Michelle Renee Zettle-Bruegger, LPC

  • Mental Health Counselor
  • Platteville, WI
National Provider Identifier
1306963822
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4845-125 Issued in WI
Practice address
1075 N Elm St
Platteville, WI 53818-1205
Phone
(608) 348-4060
Fax
(608) 348-4191
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4845-125 WI Primary

Addresses

Primary practice location

1075 N Elm St
Platteville, WI 53818-1205

Mailing address

1075 N Elm St
Platteville, WI 53818-1205
Phone (608) 348-4060

Other practice location 1

218 E Swayne St
Dodgeville, WI 53533-1291
Phone (608) 348-4060

Other identifiers 1

IdentifierTypeStateIssuer
39736000MedicaidWI

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240422000463 WI Practitioner - Mental Health Counselor 2567807225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Platteville Family Resource Center IncGroup PAC ID 0042295016, 7 clinicians

Practice addresses (Care Compare)

1075 N Elm St
Platteville, WI 53818-1205
Phone (608) 348-4060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Platteville Family Resource Center Inc CurrentSince Apr 9, 2024 Accepting new patients
Foundations Counseling Center, Inc. Mental Health Past Accepting new patients
Platteville Family Resource Center Past Accepting new patients

Locations

218 E Swayne St
Dodgeville, WI 53533

Organizations & group practices 3

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1306963822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 N ELM ST",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538181205",
            "telephone_number": "608-348-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 N ELM ST",
            "city": "PLATTEVILLE",
            "state": "WI",
            "postal_code": "538181205",
            "telephone_number": "608-348-4060",
            "fax_number": "608-348-4191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "218 E Swayne St",
            "address_purpose": "LOCATION",
            "city": "Dodgeville",
            "state": "WI",
            "postal_code": "535331291",
            "country_code": "US",
            "telephone_number": "608-348-4060",
            "fax_number": "608-348-4191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZETTLE-BRUEGGER",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "4845-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39736000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Platteville, WI

Sources for this page

Verify at the official NPI Registry.