Individual provider Active NPI

Michelle A Nelson, MFT, MSW

  • Marriage & Family Therapist
  • Milwaukee, WI
National Provider Identifier
1548409584
Registry record updated Feb 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
136-228 Issued in WI
Practice address
3200 W Highland Blvd
Milwaukee, WI 53208-3252
Phone
(414) 345-3080
NPI assigned
Feb 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 136-228 WI Primary

Addresses

Primary practice location

3200 W Highland Blvd
Milwaukee, WI 53208-3252

Mailing address

2964 Mallard Way
East Troy, WI 53120-2563
Phone (262) 264-5673

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

LicenseStateTypeSpecialty
136-228WIMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1234656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234742400000",
    "number": "1548409584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2964 MALLARD WAY",
            "city": "EAST TROY",
            "state": "WI",
            "postal_code": "531202563",
            "telephone_number": "262-264-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 W HIGHLAND BLVD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532083252",
            "telephone_number": "414-345-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MICHELLE",
        "middle_name": "A",
        "credential": "MFT, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-15",
        "last_updated": "2009-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "136-228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2009; 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.