Susan M Sebastian, LPC, CSAC. INDCS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3734-125 Issued in WI

Practice address

162 W Main St
Suite G
Whitewater, WI 53190-1995

Phone

(608) 446-0888

Fax

(866) 289-2601

NPI assigned

Jan 23, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228780800000",
    "number": "1720132053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 W MAIN ST",
            "address_2": "SUITE G",
            "city": "WHITEWATER",
            "state": "WI",
            "postal_code": "531901995",
            "telephone_number": "608-446-0888",
            "fax_number": "866-289-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 W MAIN ST",
            "address_2": "SUITE G",
            "city": "WHITEWATER",
            "state": "WI",
            "postal_code": "531901995",
            "telephone_number": "608-446-0888",
            "fax_number": "866-289-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEBASTIAN",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "LPC, CSAC. INDCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3734-125",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "2050-132",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39394800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Jean Safer, PTA
• Mamandoma Sam-Kpakra, RISGISTERED NURSE
• Holli Theresia Schaible, LAT
• Jamie Schneider, DPT
• Maxwell Harvey Schneider
• John Schaaf Sheldon, R.PH
• Shoptikal LLC (Shopko Optical 4287)
• Casey Diane Sidders, D.D.S
• Megan Kay Smith
• Solutions Psychotherapy

• Professional Counselor in Whitewater, WI
• Providers in Whitewater, 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 9, 2008; 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.