Individual provider Active NPI

Tracy Lynn Doro-Krueger, LPC

  • Professional Counselor
  • Mequon, WI
National Provider Identifier
1366774689
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
Forward Family Therapy, LLC
10535 N Port Washington Road, Suite 204
Mequon, WI 53092
Phone
(414) 324-0718
NPI assigned
Feb 11, 2010
Last updated
Jun 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

Forward Family Therapy, LLC
10535 N Port Washington Road, Suite 204
Mequon, WI 53092

Mailing address

10535 N Port Washington Road
Suite 204
Mequon, WI 53092
Phone (414) 324-0718

Other identifiers 1

IdentifierTypeStateIssuer
4340-125OtherWIWI LICENSE

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
I20240325000448 WI Practitioner - Mental Health Counselor 5496192619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1035 W Glen Oaks LN
Suite 204
Mequon, WI 53092-3395
Phone (262) 421-5101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Forward Family Therapy, LLC CurrentSince Jan 30, 2024 Accepting new patients
Mental Health Specialty Group PA Professional CurrentSince Jul 1, 2025 Accepting new patients

Locations

811 E Washington Ave
Madison, WI 53703
Phone (469) 466-7420

1035 W Glen Oaks Ln
Ste 204
Mequon, WI 53092
Phone (262) 241-1515

10535 N Port Washington Rd
Ste 204
Mequon, WI 53092
Phone (262) 421-5101

Organizations & group practices 2

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": "1265846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1366774689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10535 N PORT WASHINGTON ROAD",
            "address_2": "SUITE 204",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "53092",
            "telephone_number": "414-324-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FORWARD FAMILY THERAPY, LLC",
            "address_2": "10535 N PORT WASHINGTON ROAD, SUITE 204",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "53092",
            "telephone_number": "414-324-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORO-KRUEGER",
        "first_name": "TRACY",
        "middle_name": "LYNN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-11",
        "last_updated": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI LICENSE",
            "identifier": "4340-125",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.