Melissa Ptacek, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6171-125 Issued in WI

Practice address

15850 W Bluemound Rd Ste 208
Brookfield, WI 53005-6007

Phone

(262) 719-3824

NPI assigned

Jul 10, 2017

Last updated

Dec 18, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Melissa Kelly Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Anxiety Center Acquisition, LLC

  • Professional Counselor
  • Brookfield, WI
  • NPI 1043874969
  NPD (past)

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1679095814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15850 W BLUEMOUND RD",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530056022",
            "telephone_number": "262-719-3824",
            "fax_number": "262-641-9040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15850 W BLUEMOUND RD STE 208",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530056007",
            "telephone_number": "262-719-3824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PTACEK",
        "first_name": "MELISSA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6171-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "KELLY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katie J Prucha, LPC-IT
• Prunella Pharmacy LLC
• Prunella Pharmacy LLC (Prunella Pharmacy)
• Julia Lovejoy Psicihulis, M.S., L.P.C.
• Psychological Health Services LLC
• Purity Dialysis Centers, Inc (Brookfield Dialysis Center)
• Lisa Pusheck, PTA
• Olivia Quade, NP
• Sandra Dee Quaintance
• Shana N Quandt, D.D.S

• Professional Counselor in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; 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.