Individual provider Active NPI

Sue A.W. Melcher, PSY.D.

  • Psychologist
  • Appleton, WI
National Provider Identifier
1609065929
Registry record updated Apr 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2422-057 Issued in WI
Practice address
2800 E Enterprise Ave
Suite 1
Appleton, WI 54913-7889
Phone
(920) 560-4503
Fax
(920) 560-4501
NPI assigned
Oct 23, 2007
Last updated
Apr 30, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2422-057 WI Primary

Addresses

Primary practice location

2800 E Enterprise Ave
Suite 1
Appleton, WI 54913-7889

Mailing address

2800 E Enterprise Ave
Suite 1
Appleton, WI 54913-7889
Phone (920) 560-4503

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2422-057WIMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272585600000",
    "number": "1609065929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E ENTERPRISE AVE",
            "address_2": "SUITE 1",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137889",
            "telephone_number": "920-560-4503",
            "fax_number": "920-560-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E ENTERPRISE AVE",
            "address_2": "SUITE 1",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549137889",
            "telephone_number": "920-560-4503",
            "fax_number": "920-560-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELCHER",
        "first_name": "SUE",
        "middle_name": "A.W.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-23",
        "last_updated": "2010-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2422-057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.

Verify at the official NPI Registry.