Stacy Ann Miceli

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-25-80340 Issued in WI

Practice address

4125 N 124TH St Ste Aandb
Brookfield, WI 53005-1837

Phone

(920) 857-9041

Fax

(920) 857-3366

NPI assigned

Jan 20, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Integrated Developmental Services, Inc

  • Mental Health Counselor
  • Madison, WI
  • NPI 1528025954
  NPD (past)

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

{
    "created_epoch": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1396335790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10554 W CORTEZ CIR APT 1",
            "city": "FRANKLIN",
            "state": "WI",
            "postal_code": "531321517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 N 124TH ST STE AANDB",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530051837",
            "telephone_number": "920-857-9041",
            "fax_number": "920-857-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICELI",
        "first_name": "STACY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-20",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WI",
            "license": "1-25-80340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CentralReach",
            "affiliation": "N",
            "address_1": "200 N Patrick Blvd Ste 250",
            "city": "Brookfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530455883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joanne Metoff, M.D.
• Metro Milwaukee Anesthesia Associates SC
• Sarah Meuler, PT
• Courtney Meyerhofer, BCBA
• Rachel Colleen Meyers, FNP
• Michael Chiropractic Center SC
• Michael J. Logan MD, SC
• Mark A Michael, DC
• Anna M Michalkiewicz, RN
• Sophie Michalski

• Behavior Analyst in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Behavior Analyst in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; 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.