Active NPI
Cheryl Dedecker, LPC
- Professional Counselor
- West Allis, WI
National Provider Identifier
1326103466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2925-125
- Practice address
- 8901 W Lincoln Ave
West Allis, WI 53227-2409 - Phone
- (414) 773-4312
- NPI assigned
- Dec 27, 2006
- Sex
- Female
- 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 | 2925-125 | WI | Primary |
Addresses
Primary practice location
8901 W Lincoln Ave
West Allis, WI 53227-2409
Mailing address
18375 Taywood Cir
#101
Brookfield, WI 53045-5696
Phone (262) 792-8818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39738600 | 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 |
|---|---|---|---|
| 2925-125 | WI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326103466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18375 TAYWOOD CIR",
"address_2": "#101",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530455696",
"telephone_number": "262-792-8818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8901 W LINCOLN AVE",
"city": "WEST ALLIS",
"state": "WI",
"postal_code": "532272409",
"telephone_number": "414-773-4312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEDECKER",
"first_name": "CHERYL",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "2925-125",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39738600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Allis, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.