Active NPI
Rick D Miceli-Wink, CSAC
- Addiction (Substance Use Disorder) Counselor
- Green Bay, WI
National Provider Identifier
1821361833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1266
- Practice address
- 3150 Gershwin Dr
Green Bay, WI 54311-4328 - Phone
- (920) 448-6219
- Fax
- (920) 391-4870
- NPI assigned
- Feb 22, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1266 | WI | Primary |
| Clinical Social Worker | 1041C0700X | 4880 | WI |
Addresses
Primary practice location
3150 Gershwin Dr
Green Bay, WI 54311-4328
Mailing address
3150 Gershwin Dr
Green Bay, WI 54311-4328
Phone (920) 448-6219
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4880 | WI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329868800000",
"number": "1821361833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3150 GERSHWIN DR",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543114328",
"telephone_number": "920-448-6219",
"fax_number": "920-391-4870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3150 GERSHWIN DR",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543114328",
"telephone_number": "920-448-6219",
"fax_number": "920-391-4870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICELI-WINK",
"first_name": "RICK",
"middle_name": "D",
"credential": "CSAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-22",
"last_updated": "2012-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "1266",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "4880",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.