Active NPI
Susan Nolte, LMFT
- Marriage & Family Therapist
- Mequon, WI
National Provider Identifier
1518523356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 777-124
- Practice address
- 11512 N Port Washington Rd Ste 201G
Mequon, WI 53092-3456 - Phone
- (414) 502-9878
- NPI assigned
- May 16, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 777-124 | WI | Primary |
Addresses
Primary practice location
11512 N Port Washington Rd Ste 201G
Mequon, WI 53092-3456
Mailing address
124 W Freistadt Rd
PO Box 665
Thiensville, WI 53092
Other practice location 1
234 W Florida St Ste 211
Milwaukee, WI 53204-1659
Phone (502) 987-8414
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 |
|---|---|---|---|
| 777-124 | WI | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557964800000",
"number": "1518523356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 W FREISTADT RD",
"address_2": "PO BOX 665",
"city": "THIENSVILLE",
"state": "WI",
"postal_code": "53092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11512 N PORT WASHINGTON RD STE 201G",
"city": "MEQUON",
"state": "WI",
"postal_code": "530923456",
"telephone_number": "414-502-9878"
}
],
"practiceLocations": [
{
"address_1": "234 W Florida St Ste 211",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532041659",
"country_code": "US",
"telephone_number": "502-987-8414",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NOLTE",
"first_name": "SUSAN",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-05-16",
"last_updated": "2019-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WI",
"license": "777-124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mequon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.