Individual provider Active NPI

Miriam Ninmann, LMFT-IT

  • Marriage & Family Therapist
  • West Bend, WI
National Provider Identifier
1760330450
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1214-228 Issued in WI
Practice address
1615 Barton Ave
West Bend, WI 53090-2029
Phone
(262) 375-1116
NPI assigned
Mar 18, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1214-228 WI Primary

Addresses

Primary practice location

1615 Barton Ave
West Bend, WI 53090-2029

Mailing address

N112W16298 Mequon Rd Ste 291
Germantown, WI 53022-3306

Other practice location 1

10535 N Port Washington Rd Ste 204
Mequon, WI 53092-5560
Phone (262) 421-5101

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

State licenses

LicenseStateTypeSpecialty
1214-228WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Forward Family Therapy, LLC PastSince May 25, 2025 Accepting new patients
Northshore Clinic & Consultants, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1773792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1760330450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N112W16298 MEQUON RD STE 291",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530223306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 BARTON AVE",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530902029",
            "telephone_number": "262-375-1116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10535 N Port Washington Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530925560",
            "country_code": "US",
            "telephone_number": "262-421-5101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NINMANN",
        "first_name": "MIRIAM",
        "credential": "LMFT-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-18",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "1214-228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.