Individual provider Active NPI

Mary Ellen Fitts, MSW

  • Marriage & Family Therapist
  • Cedarburg, WI
National Provider Identifier
1457490559
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
198124 Issued in WI
Practice address
W62 N248 Washington Avenue
Suite #207
Cedarburg, WI 53012
Phone
(262) 375-1116
Fax
(262) 375-1071
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2001123 WI
Marriage & Family Therapist 106H00000X 198124 WI Primary

Addresses

Primary practice location

W62 N248 Washington Avenue
Suite #207
Cedarburg, WI 53012

Mailing address

4941 County Road Z
West Bend, WI 53095
Phone (262) 677-0735

Other identifiers 1

IdentifierTypeStateIssuer
39254400MedicaidWI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2001123WIMDClinical Social Worker
198124WIMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1457490559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4941 COUNTY ROAD Z",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "53095",
            "telephone_number": "262-677-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W62 N248 WASHINGTON AVENUE",
            "address_2": "SUITE #207",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "53012",
            "telephone_number": "262-375-1116",
            "fax_number": "262-375-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITTS",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2001123",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "198124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39254400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedarburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.