Active NPI
Sedoria Outlaw, MA
- Professional Counselor
- Milwaukee, WI
National Provider Identifier
1598083008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 218226
- Practice address
- 4828 W Fond Du Lac Ave
Milwaukee, WI 53216-2323 - Phone
- (414) 899-0109
- NPI assigned
- May 7, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 218226 | WI | Primary |
Addresses
Primary practice location
4828 W Fond Du Lac Ave
Milwaukee, WI 53216-2323
Mailing address
P O Box 153
Milwaukee, WI 53201
Phone (414) 899-0109
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 218226 | Other | WI | LICENSE |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 218226 | WI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273190400000",
"number": "1598083008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 153",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "53201",
"telephone_number": "414-899-0109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4828 W FOND DU LAC AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532162323",
"telephone_number": "414-899-0109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OUTLAW",
"first_name": "SEDORIA",
"name_prefix": "Miss",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-07",
"last_updated": "2010-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "218226",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "218226",
"state": "WI"
}
],
"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 May 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.