Individual provider Active NPI

Laura Selker, MA, LMFT

  • Marriage & Family Therapist
  • New London, WI
National Provider Identifier
1679083729
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
536-228 Issued in WI
Practice address
E7475 Rawhide Rd
New London, WI 54961-9025
Phone
(877) 300-9101
Fax
(920) 531-2686
NPI assigned
Oct 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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 536-228 WI Primary

Addresses

Primary practice location

E7475 Rawhide Rd
New London, WI 54961-9025

Mailing address

E7475 Rawhide Rd
New London, WI 54961-9025
Phone (877) 300-9101

Other practice location 1

446 N Westhill Blvd Ste 6
Appleton, WI 54914-6533
Phone (920) 931-4350

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

LicenseStateTypeSpecialty
536-228WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rawhide Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: laura.selker@25254901.chartlogic.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1679083729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E7475 RAWHIDE RD",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549619025",
            "telephone_number": "877-300-9101",
            "fax_number": "920-531-2686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E7475 RAWHIDE RD",
            "city": "NEW LONDON",
            "state": "WI",
            "postal_code": "549619025",
            "telephone_number": "877-300-9101",
            "fax_number": "920-531-2686"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "446 N Westhill Blvd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549146533",
            "country_code": "US",
            "telephone_number": "920-931-4350",
            "fax_number": "920-257-4460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELKER",
        "first_name": "LAURA",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-03",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "536-228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.