Judith Geralyn Tegge, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

5555 N Port Washington Rd
Suite 200
Glendale, WI 53217-4929

Phone

(262) 789-1191

Fax

(414) 967-7965

NPI assigned

May 22, 2013

Last updated

May 22, 2013By the provider in NPPES

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 identifiers 2

Other names 1

• Miss Judith Geralyn Heezen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369180800000",
    "number": "1700222338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 N PORT WASHINGTON RD",
            "address_2": "SUITE 200",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174929",
            "telephone_number": "262-789-1191",
            "fax_number": "414-967-7965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 N PORT WASHINGTON RD",
            "address_2": "SUITE 200",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532174929",
            "telephone_number": "262-789-1191",
            "fax_number": "414-967-7965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEGGE",
        "first_name": "JUDITH",
        "middle_name": "GERALYN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-22",
        "last_updated": "2013-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE (P-TAN) MILWAUKEE COUNTY",
            "identifier": "000-088745",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42170300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUDITH",
            "last_name": "HEEZEN",
            "middle_name": "GERALYN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeanine Marie Swenson, M.D.
• Todd M Swenson, MD
• Karen Sue Tait I, D.T. (DIETETIC TECH)
• Heather Talley, LPC
• Primo R Tamayo, M.D.
• The Cambridge Group
• Therapized LLC
• Thomas B. Huizenga, M.D.,S.C.
• Mary Rudolph Thomas, PT
• Zachary Lee Thomason, OD

• Mental Health Counselor in Glendale, WI
• Providers in Glendale, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2013; 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.