Individual provider Active NPI

Melissa A Suchalla, LPC

  • Professional Counselor
  • Green Bay, WI
National Provider Identifier
1336455591
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4400-125 Issued in WI
Practice address
301 E Saint Joseph St
Green Bay, WI 54301-2241
Phone
(920) 433-3630
NPI assigned
Aug 26, 2010
Last updated
Feb 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 4400-125 WI
Professional Counselor 101YP2500X 4400-125 WI Primary

Addresses

Primary practice location

301 E Saint Joseph St
Green Bay, WI 54301-2241

Mailing address

301 E Saint Joseph St
Green Bay, WI 54301-2241
Phone (920) 433-3630

Other practice location 1

720 S VanBuren St
Green Bay, WI 54301-3534
Phone (920) 433-6073

Other practice location 2

1630 Commanche Ave
Green Bay, WI 54313-5753
Phone (920) 430-4780

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240325001452 WI Practitioner - Mental Health Counselor 5496106023 Reassigns benefits to 2 organizations
I20240927001362 MI Practitioner - Mental Health Counselor 5496106023 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4400-125WIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Professional CurrentSince May 23, 2025 Accepting new patients
Oconto Hospital & Medical Center, Inc. CurrentSince Sep 23, 2024 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Sep 23, 2024 Accepting new patients
Oconto Hospital & Medical Center, Inc. Current Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Memorial Hospital CurrentSince May 23, 2025 Accepting new patients
Bellin Psychiatric Center Inc. CurrentSince Feb 1, 2024 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Bellin Psychiatric Center Inc. Current Accepting new patients
Bellin Psychiatric Center Inc Current Accepting new patients

Locations

106 S School Rd
Daggett, MI 49821
Phone (906) 753-2155

440 Woodward Ave
Iron Mountain, MI 49801
Phone (906) 776-9040

1100 10th St
Menominee, MI 49858
Phone (906) 863-2256

1630 Commanche Ave
Green Bay, WI 54313
Phone (920) 430-4700

301 Saint Joseph St
Green Bay, WI 54301
Phone (920) 430-3630

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1336455591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E SAINT JOSEPH ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012241",
            "telephone_number": "920-433-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E SAINT JOSEPH ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012241",
            "telephone_number": "920-433-3630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 S VanBuren St",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013534",
            "country_code": "US",
            "telephone_number": "920-433-6073",
            "fax_number": "920-432-6313",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1630 Commanche Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543135753",
            "country_code": "US",
            "telephone_number": "920-430-4780",
            "fax_number": "920-430-4787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUCHALLA",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "4400-125",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4400-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.