NPIMap

Organization Active NPI

Exodus Counseling Center, Inc.

  • Mental Health Counselor
  • Glendale, WI
National Provider Identifier
1871713628
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
STATE MANDATED Issued in WI
Legal business name
EXODUS COUNSELING CENTER, INC.
Practice address
5800 North Bayshore Drive
Suite B 204
Glendale, WI 53217
Phone
(414) 964-4357
Fax
(414) 964-4327
NPI assigned
Apr 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Scott Stoner, D.MIN.
Title
Executive Director
Phone
(414) 964-4357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X STATE MANDATED WI Primary

Addresses

Primary practice location

5800 North Bayshore Drive
Suite B 204
Glendale, WI 53217

Mailing address

5800 North Bayshore Dr
Suite B 204
Glendale, WI 53217
Phone (414) 964-4357

National Provider Directory

National Provider Directory

Locations

5800 N Bayshore Dr
Ste B
Glendale, WI 53217
Phone (414) 962-4048

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871713628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 NORTH BAYSHORE DR",
            "address_2": "SUITE B 204",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-964-4357",
            "fax_number": "414-964-4327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 NORTH BAYSHORE DRIVE",
            "address_2": "SUITE B 204",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "53217",
            "telephone_number": "414-964-4357",
            "fax_number": "414-964-4327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXODUS COUNSELING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STONER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "414-964-4357",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.MIN."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "STATE MANDATED",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.