Individual provider Active NPI

Michelle Lynn Willes, MGC, CGC

  • Genetic Counselor (M.S.)
  • Milwaukee, WI
National Provider Identifier
1619740065
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Genetic Counselor (M.S.)Taxonomy code 170300000X
License
1261-61 Issued in WI
Practice address
8915 W Connell Ave
Milwaukee, WI 53226-3067
Phone
(414) 266-3347
NPI assigned
Nov 6, 2023
Last updated
Dec 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.) 170300000X 1261-61 WI Primary

Addresses

Primary practice location

8915 W Connell Ave
Milwaukee, WI 53226-3067

Mailing address

PO Box 1997
Milwaukee, WI 53201-1997
Phone (414) 266-3347

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
1261-61WIMDGenetic Counselor (M.S.)

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1619740065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1997",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532011997",
            "telephone_number": "414-266-3347",
            "fax_number": "141-266-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8915 W CONNELL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263067",
            "telephone_number": "414-266-3347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLES",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "credential": "MGC, CGC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "WI",
            "license": "1261-61",
            "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 Dec 4, 2023; 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.