Active NPI
Emily Mierendorf, LPC
- Professional Counselor
- Brookfield, WI
National Provider Identifier
1619623337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 8270-125
- Practice address
- 150 N Sunny Slope Rd Ste 100
Brookfield, WI 53005-4806 - Phone
- (262) 432-5660
- NPI assigned
- Feb 22, 2022
- 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 | 8270-125 | WI | Primary |
Addresses
Primary practice location
150 N Sunny Slope Rd Ste 100
Brookfield, WI 53005-4806
Mailing address
6225 Smith Ave Ste 1001a
Baltimore, MD 21209-3626
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 |
|---|---|---|---|
| 8270-125 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Autism Spectrum Therapies, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Behavior Analyst
- Burbank, CA
- NPI 1609194000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645488000000",
"number": "1619623337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6225 SMITH AVE STE 1001A",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212093626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 N SUNNY SLOPE RD STE 100",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530054806",
"telephone_number": "262-432-5660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIERENDORF",
"first_name": "EMILY",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-22",
"last_updated": "2022-02-22",
"certification_date": "2022-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "8270-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.