Active NPI
Susan C. Kruzel, LPC
- Professional Counselor
- Grand Chute, WI
National Provider Identifier
1891011292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 5104-125
- Practice address
- 3460 N Spruce St
Grand Chute, WI 54914-1449 - Phone
- (920) 450-4504
- NPI assigned
- Apr 12, 2010
- Last updated
- Jun 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 5104-125 | WI | Primary |
Addresses
Primary practice location
3460 N Spruce St
Grand Chute, WI 54914-1449
Mailing address
3460 N Spruce St
Grand Chute, WI 54914-1449
Phone (920) 450-4504
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 |
|---|---|---|---|
| 5104-125 | WI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592352000000",
"number": "1891011292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3460 N SPRUCE ST",
"city": "GRAND CHUTE",
"state": "WI",
"postal_code": "549141449",
"telephone_number": "920-450-4504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3460 N SPRUCE ST",
"city": "GRAND CHUTE",
"state": "WI",
"postal_code": "549141449",
"telephone_number": "920-450-4504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRUZEL",
"first_name": "SUSAN",
"middle_name": "C.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-12",
"last_updated": "2020-06-17",
"certification_date": "2020-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "5104-125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Chute, WI
- Rory L Fry, MD
- Adam C. Geske, PT, DPT
- Mark Gordon, PHARMD
- Laura Jasperson, PHARM.D.
- Mary Kirchner
- Meijer Stores Limited Partnership (Meijer Pharmacy #300)
- Roundys Supermarkets Inc (Pick N Save Pharmacy)
- Abigail Schreiber, DPT
- Shoptikal LLC (Shopko Optical 4220)
- St Vincent Hospital-Hospital Sisters-Third Order of St Francis (Prevea Health)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.