Michele Anne Fitzgerald, MSED, CSAC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5453-125 Issued in WI

Practice address

1500 N 34TH St
Suite 200
Superior, WI 54880-4477

Phone

(715) 392-8216

Fax

(715) 392-6055

NPI assigned

Feb 21, 2012

Last updated

Mar 23, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  Medicare reassignment NPD
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  • NPI 1245845932

  MN

  Medicare reassignment

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1801169917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 TOWER AVE",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "54880",
            "telephone_number": "715-392-1955",
            "fax_number": "715-392-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N 34TH ST",
            "address_2": "SUITE 200",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548804477",
            "telephone_number": "715-392-8216",
            "fax_number": "715-392-6055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 N 34th St",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Superior",
            "state": "WI",
            "postal_code": "548804477",
            "country_code": "US",
            "telephone_number": "715-395-5380",
            "fax_number": "715-392-1935",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 Tower Ave",
            "address_purpose": "LOCATION",
            "city": "Superior",
            "state": "WI",
            "postal_code": "548805337",
            "country_code": "US",
            "telephone_number": "715-392-1955",
            "fax_number": "715-392-1935",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 N 34th St",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Superior",
            "state": "WI",
            "postal_code": "548804477",
            "country_code": "US",
            "telephone_number": "715-392-8216",
            "fax_number": "715-392-6055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "MICHELE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "MSED, CSAC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-21",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "1651-132",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5453-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay Michael Ferguson, PA-C
• Jacob W Ferris
• Shena Fesenmaier
• Elaina A Fischer, APRN,CNP
• Erin Lee Fisker, PA-C
• Kristen Bree Flaherty, DPT
• Lindi Marie Flemmen, PT
• Ruby Kay Flynn
• Amy Jo Folkestad, COTA/L
• Ahsha Ford

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.