Individual provider Active NPI

Crystal Sheehy, MS, LMFT

  • Marriage & Family Therapist
  • Madison, WI
National Provider Identifier
1710423108
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1202-124 Issued in WI
Practice address
6502 Grand Teton PLZ
Suite 204
Madison, WI 53719-1047
Phone
(608) 338-1786
NPI assigned
Jan 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1202-124 WI Primary
Marriage & Family Therapist 106H00000X 568-228 WI

Addresses

Primary practice location

6502 Grand Teton PLZ
Suite 204
Madison, WI 53719-1047

Mailing address

6502 Grand Teton PLZ
Suite 204
Madison, WI 53719-1047

Other practice location 1

17 S River St Ste 254
Janesville, WI 53548-3863
Phone (608) 755-5260

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 Science

State licenses

LicenseStateTypeSpecialty
1202-124WIMDMarriage & Family Therapist
568-228WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Mind Therapy LLC Marriage & Family Therapist Past Accepting new patients
Trivium LLC PastSince Sep 1, 2008 Accepting new patients
Trivium LLC Past Accepting new patients

Organizations & group practices 3

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": "1484006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1710423108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6502 GRAND TETON PLZ",
            "address_2": "SUITE 204",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6502 GRAND TETON PLZ",
            "address_2": "SUITE 204",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191047",
            "telephone_number": "608-338-1786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17 S River St Ste 254",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535483863",
            "country_code": "US",
            "telephone_number": "608-755-5260",
            "fax_number": "608-755-5267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEEHY",
        "first_name": "CRYSTAL",
        "credential": "MS, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-10",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "1202-124",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "568-228",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.