Individual provider Active NPI

Suzan A M McVicker, MA, LPC

  • Professional Counselor
  • Madison, WI
National Provider Identifier
1457421992
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3334-125 Issued in WI
Practice address
122 E Olin Ave Ste 220
Madison, WI 53713-1482
Phone
(608) 255-9119
Fax
(608) 255-9219
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3334-125 WI Primary

Addresses

Primary practice location

122 E Olin Ave Ste 220
Madison, WI 53713-1482

Mailing address

2141 Chamberlain Ave
Madison, WI 53726-3977
Phone (608) 255-9119

Other identifiers 1

IdentifierTypeStateIssuer
3334-125OtherWILICENSED PROFESSIONAL COU

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3334-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Psychology Associates LLP Professional PastSince Oct 10, 2005 Accepting new patients

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457421992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 CHAMBERLAIN AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537263977",
            "telephone_number": "608-255-9119",
            "fax_number": "608-255-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E OLIN AVE STE 220",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537131482",
            "telephone_number": "608-255-9119",
            "fax_number": "608-255-9219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCVICKER",
        "first_name": "SUZAN",
        "middle_name": "A M",
        "name_prefix": "Ms.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3334-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COU",
            "identifier": "3334-125",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.