Madison Art Therapy LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

MADISON ART THERAPY LLC

Practice address

700 Ray O Vac Dr Ste 320
Madison, WI 53711-2471

Phone

(608) 520-0846

Fax

(608) 709-1079

NPI assigned

Nov 5, 2019

Organization subpart

No

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

Authorized official

Name

Kelly J Toltzien, LPC, ATR, WATR

Title

Member/Art Therapist

Phone

(608) 520-0846

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572912000000",
    "number": "1528602299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 RAY O VAC DR STE 320",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112471",
            "telephone_number": "608-520-0846",
            "fax_number": "608-709-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 RAY O VAC DR STE 320",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112471",
            "telephone_number": "608-520-0846",
            "fax_number": "608-709-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON ART THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-05",
        "last_updated": "2019-11-05",
        "status": "A",
        "authorized_official_last_name": "TOLTZIEN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMBER/ART THERAPIST",
        "authorized_official_telephone_number": "608-520-0846",
        "authorized_official_credential": "LPC, ATR, WATR"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "221700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Art Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.