Active NPI
Paul J Melrose, LMFT
- Marriage & Family Therapist
- Monona, WI
National Provider Identifier
1457572984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1026-124
- Practice address
- 5900 Monona Dr
Suite 100
Monona, WI 53716-3554 - Phone
- (608) 663-0763
- Fax
- (608) 663-0765
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 4101006221 | MI | |
| Marriage & Family Therapist | 106H00000X | 1026-124 | WI | Primary |
Addresses
Primary practice location
5900 Monona Dr
Suite 100
Monona, WI 53716-3554
Mailing address
5900 Monona Dr
Suite 100
Monona, WI 53716-3554
Phone (608) 663-0763
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4101006221 | MI | MD | Marriage & Family Therapist |
| 1026-124 | WI | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Samaritan Counseling Center | Past | Accepting new patients | |
| Samaritan Counseling Center of Southern Wisconsin Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Adult Mental Health Clinic/Center
- Monona, WI
- NPI 1205077427
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Monona, WI
- NPI 1962544353
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437609600000",
"number": "1457572984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5900 MONONA DR",
"address_2": "SUITE 100",
"city": "MONONA",
"state": "WI",
"postal_code": "537163554",
"telephone_number": "608-663-0763",
"fax_number": "608-663-0765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 MONONA DR",
"address_2": "SUITE 100",
"city": "MONONA",
"state": "WI",
"postal_code": "537163554",
"telephone_number": "608-663-0763",
"fax_number": "608-663-0765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELROSE",
"first_name": "PAUL",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2015-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MI",
"license": "4101006221",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WI",
"license": "1026-124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Monona, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.