NPIMap

Organization Active NPI

Bridgeport Counseling

  • Professional Counselor
  • Superior, WI
National Provider Identifier
1427208784
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2837-125 Issued in WI
Legal business name
BRIDGEPORT COUNSELING
Practice address
2231 Catlin Ave
Room #310
Superior, WI 54880-5137
Phone
(715) 395-7825
Fax
(715) 395-7826
NPI assigned
Sep 23, 2008
Last updated
Sep 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Authorized official

Name
Mr. Timothy Lloyd Panula, LPCNPI 1548445778
Title
Licensed Professional Counselor
Phone
(715) 395-7825

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 2837-125 WI Primary

Addresses

Primary practice location

2231 Catlin Ave
Room #310
Superior, WI 54880-5137

Mailing address

2231 Catlin Ave
Room #310
Superior, WI 54880-5137
Phone (715) 395-7825

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1427208784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2231 CATLIN AVE",
            "address_2": "ROOM #310",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548805137",
            "telephone_number": "715-395-7825",
            "fax_number": "715-395-7826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 CATLIN AVE",
            "address_2": "ROOM #310",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548805137",
            "telephone_number": "715-395-7825",
            "fax_number": "715-395-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEPORT COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "PANULA",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "715-395-7825",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "2837-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Superior, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.