Individual provider Active NPI

Tessa Reynolds

  • Mental Health Counselor
  • Milwaukee, WI
National Provider Identifier
1407552425
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
10012 W Capitol Dr
Milwaukee, WI 53222-1338
Phone
(414) 810-4844
NPI assigned
Feb 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

10012 W Capitol Dr
Milwaukee, WI 53222-1338

Mailing address

6008 W Grant St
West Allis, WI 53219-1443
Phone (262) 949-6090

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Grove Clinic, SC CurrentSince Feb 29, 2012 Accepting new patients

Locations

10012 W Capitol Dr
Ste 101
Wauwatosa, WI 53222
Phone (414) 810-4844

10012 W Capitol Dr
Wauwatosa, WI 53222
Phone (414) 810-4844

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1407552425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6008 W GRANT ST",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532191443",
            "telephone_number": "262-949-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532221338",
            "telephone_number": "414-810-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "TESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.