Individual provider Active NPI

Melissa Bendever

  • Addiction (Substance Use Disorder) Counselor
  • Milwaukee, WI
National Provider Identifier
1891109260
Registry record updated Jun 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
17044-130 Issued in WI
Practice address
1111 South 6TH Street
Milwaukee, WI 53204
Phone
(414) 643-8530
Fax
(414) 647-8602
NPI assigned
Jun 13, 2014
Last updated
Jun 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 17044-130 WI Primary

Addresses

Primary practice location

1111 South 6TH Street
Milwaukee, WI 53204

Mailing address

1111 S 6TH St
Milwaukee, WI 53204-2301
Phone (414) 643-8530

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

LicenseStateTypeSpecialty
17044-130WIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1891109260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 S 6TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532042301",
            "telephone_number": "414-643-8530",
            "fax_number": "414-647-8602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SOUTH 6TH STREET",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53204",
            "telephone_number": "414-643-8530",
            "fax_number": "414-647-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENDEVER",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-13",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17044-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; 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.