Autumn Marzette-Anderson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

2901 35TH St
Kenosha, WI 53140-5117

Phone

(262) 764-2459

Fax

(262) 558-0429

NPI assigned

Oct 1, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Autumn Marzette Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Be Insightful

  • Adult Mental Health Clinic/Center
  • Kenosha, WI
  • NPI 1073110631
  NPD
• Professional Services Group, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kenosha, WI
  • NPI 1619024262
  NPD

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1689346207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 35TH ST LOWR SUITEB",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531405117",
            "telephone_number": "262-764-2459",
            "fax_number": "262-558-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 35TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531405117",
            "telephone_number": "262-764-2459",
            "fax_number": "262-558-0429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARZETTE-ANDERSON",
        "first_name": "AUTUMN",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUTUMN",
            "last_name": "MARZETTE",
            "prefix": "MRS.",
            "credential": "LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Erin Martin, COTA
• Tyler Martin, MA, ATC, LAT
• Amanda A Martinez
• Jessica Martzahl, LPC
• David T Marx, PSY.D.
• Molly Mason, CRNA
• Ann Mastrostefano, COTA
• Nicholas Masyga
• Rodrigo A Mata Jr., M.D.
• Rodrigo Buencamino Mata III, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.