Individual provider Active NPI

Gail Sell, MA LMFT

  • Marriage & Family Therapist
  • Green Bay, WI
National Provider Identifier
1851468227
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
610-124 Issued in WI
Practice address
2300 Lineville Rd
Suite 200
Green Bay, WI 54313-8859
Phone
(920) 434-7457
Fax
(920) 434-7460
NPI assigned
Nov 29, 2006
Last updated
Nov 29, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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 610-124 WI Primary

Addresses

Primary practice location

2300 Lineville Rd
Suite 200
Green Bay, WI 54313-8859

Mailing address

2300 Lineville Rd
Suite 201
Green Bay, WI 54313-8859
Phone (920) 434-7457

Other identifiers 1

IdentifierTypeStateIssuer
39737600MedicaidWI

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
610-124WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Family Resources & Associates LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1851468227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 LINEVILLE RD",
            "address_2": "SUITE 201",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543138859",
            "telephone_number": "920-434-7457",
            "fax_number": "920-434-7460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 LINEVILLE RD",
            "address_2": "SUITE 200",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543138859",
            "telephone_number": "920-434-7457",
            "fax_number": "920-434-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELL",
        "first_name": "GAIL",
        "credential": "MA LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "610-124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39737600",
            "state": "WI"
        }
    ],
    "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 Nov 29, 2011; 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.