Susan Ignazito-Wilhelm, MAC, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

2011039644 Issued in MO

Practice address

3134 Sutton Blvd
Maplewood, MO 63143-3910

Phone

(314) 375-6475

NPI assigned

May 4, 2012

Last updated

May 15, 2019By 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 1

Medicare fee-for-service enrollment

Enrolled in MO

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

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.

• My Blue Skies LLC

  • Community/Behavioral Health Agency
  • Richmond Heights, MO
  • NPI 1720844756
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1811256332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7218 TALL OAK CT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631295650",
            "telephone_number": "314-375-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3134 SUTTON BLVD",
            "city": "MAPLEWOOD",
            "state": "MO",
            "postal_code": "631433910",
            "telephone_number": "314-375-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGNAZITO-WILHELM",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "MAC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2011039644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "499508802",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maggie Goodwin
• Daniel Graham, PHARMD
• Carl R Hoelting, OD
• Holistic Family Practice LLC
• Davontre Holland
• J. W. H. Healthcare Services
• Rebecca Gould Karlen, DC
• Jonathan J Kidd, CNIM
• Gregory Foster Kleinschmidt, D.C.
• Riley Marie Krus

• Counselor in Maplewood, MO
• Providers in Maplewood, MO by specialty
• Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; 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.