Shelly Wissink, MS, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6856-125 Issued in WI

Practice address

429 Gammon PL Ste 200
Madison, WI 53719-1053

Phone

(608) 772-9582

NPI assigned

Aug 15, 2018

Last updated

Apr 18, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587168000000",
    "number": "1407336985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 GAMMON PL STE 200",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 GAMMON PL STE 200",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191053",
            "telephone_number": "608-772-9582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISSINK",
        "first_name": "SHELLY",
        "name_prefix": "Ms.",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2020-04-18",
        "certification_date": "2020-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "6856-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shellyw@harmonycw.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "429 Gammon Pl Ste 200",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537191053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carol W Wish, PH. D.
• Joel R Wish
• Kari Braun Wisinski, MD
• Leah Suzanne Wisniewski, PA-C
• Han Kyung Lee Wissink, PHARMD
• Megan Wissler, DPT
• Nicole Catherine Wiswell, LPC
• Alex M Witek
• Matthew Edward Witek, MD
• With in Sight, LLC

• Mental Health Counselor in Madison, WI
• Providers in Madison, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2020; 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.