Michelle L Waack, MAC, LPC, CSAC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

8568-125 Issued in WI

Practice address

1270 Main St Ste 120
Green Bay, WI 54302-1337

Phone

(920) 288-2846

Fax

(920) 770-4153

NPI assigned

Nov 12, 2019

Last updated

Nov 16, 2022By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Meraki Therapy & Wellness, LLC

  • Counselor
  • Green Bay, WI
  • NPI 1407593619
  NPD Authorized official

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1336784545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 MAIN ST STE 120",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543021337",
            "telephone_number": "920-288-2846",
            "fax_number": "920-770-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 MAIN ST STE 120",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543021337",
            "telephone_number": "920-288-2846",
            "fax_number": "920-770-4153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAACK",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MAC, LPC, CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-12",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WI",
            "license": "8568-125",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16594-132",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100095134",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Voss Eyecare SC
• Jade Vosters, APNP
• Samantha Vouyiouklis, MD
• Voyager Drive Dental, SC
• Voyager Family Dental LLC
• Jennifer M Wachowiak, PMHNP-BC
• Heather J. Wade Newell, MD
• William Joseph Wadzinski, MD
• Elizabeth Ann Waerzeggers, MPT
• Elizabeth A Wagner, NP

• Counselor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.