Mary Therese Sosalla, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

7323-125 Issued in WI

Practice address

4811 S 76TH St # 305
Greenfield, WI 53220-4364

Phone

(414) 325-7741

NPI assigned

Mar 2, 2017

Last updated

Jul 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Child & Family Therapeutic Systems S.C.

  dba Child & Family Therapeutic Systems

  • Clinical Social Worker
  • Greenfield, WI
  • NPI 1922176395
  NPD (past)

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1427598002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4811 S 76TH ST # 305",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204364",
            "telephone_number": "414-325-7741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 S 76TH ST # 305",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204364",
            "telephone_number": "414-325-7741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 W End Ct",
            "address_2": "#900",
            "address_purpose": "LOCATION",
            "city": "Vernon Hills",
            "state": "IL",
            "postal_code": "600611365",
            "country_code": "US",
            "telephone_number": "847-362-2111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2625 Butterfield Rd Ste 101N",
            "address_purpose": "LOCATION",
            "city": "Oak Brook",
            "state": "IL",
            "postal_code": "605233405",
            "country_code": "US",
            "telephone_number": "630-586-0900 x31",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOSALLA",
        "first_name": "MARY",
        "middle_name": "THERESE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-02",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.011135",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "7323-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Greenfield, WI
• Providers in Greenfield, 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 Jul 9, 2019; 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.