Unmasked Expressive Therapies

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6745-125 Issued in WI

Legal business name

UNMASKED EXPRESSIVE THERAPIES

Practice address

207 N Spring St
Beaver Dam, WI 53916-2115

Phone

(920) 219-9448

NPI assigned

Jun 12, 2018

Organization subpart

No

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

Authorized official

Name

Tami Joe Delisle, ATR-BC, LPCNPI 1609242825

Title

Executive Director

Phone

(920) 382-0445

Specialties & licenses 1

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tami Joe Delisle, LPC, ATR-BC

  • Mental Health Counselor
  • Beaver Dam, WI
  • NPI 1609242825
  NPD Authorized official
• Katie Marie Hari, LPC, ATR

  • Mental Health Counselor
  • Fond Du Lac, WI
  • NPI 1366909236
  NPD (past)
• Tyler John Marx, LPC-IT

  • Mental Health Counselor
  • Beaver Dam, WI
  • NPI 1437993029
  NPD (past)
• Elizabeth Marie Szalewski, ATR, LPC

  • Mental Health Counselor
  • Beaver Dam, WI
  • NPI 1649765355
  NPD (past)

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1407349657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 S UNIVERSITY AVE STE 1",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162464",
            "telephone_number": "920-219-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 N SPRING ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162115",
            "telephone_number": "920-219-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNMASKED EXPRESSIVE THERAPIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-12",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A",
        "authorized_official_last_name": "DELISLE",
        "authorized_official_first_name": "TAMI",
        "authorized_official_middle_name": "JOE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "920-382-0445",
        "authorized_official_credential": "ATR-BC, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "6745-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas J. Triller, DDS
• Tyjeski Family Chiropractic
• Jerome E Tyjeski, DC
• Joshua Jerome Tyjeski, D.C.
• University of Wisconsin Medical Foundation Inc
• David Charles Utrie, D.D.S.
• Angela Kay Van Ooyen, MS, CCC-SLP
• Ellen Marie Vander Galien
• Kim Marie Vander Galien, COTA
• William Vansusteren, MS, LPC-IT

• Mental Health Counselor in Beaver Dam, WI
• Providers in Beaver Dam, 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 Nov 5, 2024; 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.