Active NPI
Samantha J Sonnentag
- Professional Counselor
- Appleton, WI
National Provider Identifier
1356699615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1496-226
- Practice address
- 5497 W Waterford LN
Suite a
Appleton, WI 54913-8509 - Phone
- (920) 750-6120
- Fax
- (920) 750-6121
- NPI assigned
- Aug 16, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 1496-226 | WI | Primary |
Addresses
Primary practice location
5497 W Waterford LN
Suite a
Appleton, WI 54913-8509
Mailing address
W6065 Jessica LN
Appleton, WI 54915-7442
Phone (920) 585-7639
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 |
|---|---|---|---|
| 1496-226 | WI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345075200000",
"number": "1356699615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W6065 JESSICA LN",
"city": "APPLETON",
"state": "WI",
"postal_code": "549157442",
"telephone_number": "920-585-7639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5497 W WATERFORD LN",
"address_2": "SUITE A",
"city": "APPLETON",
"state": "WI",
"postal_code": "549138509",
"telephone_number": "920-750-6120",
"fax_number": "920-750-6121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONNENTAG",
"first_name": "SAMANTHA",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-16",
"last_updated": "2012-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "1496-226",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.