Active NPI
Lana M Nassen, LPC
- Mental Health Counselor
- Glendale, WI
National Provider Identifier
1891882429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4165-125
- Practice address
- 6980 N Port Washington Rd
202
Glendale, WI 53217-3900 - Phone
- (414) 351-7100
- Fax
- (414) 247-4082
- NPI assigned
- Oct 6, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 3036 | CO | |
| Mental Health Counselor | 101YM0800X | 4165-125 | WI | Primary |
Addresses
Primary practice location
6980 N Port Washington Rd
202
Glendale, WI 53217-3900
Mailing address
6980 N Port Washington Rd
202
Glendale, WI 53217-3900
Phone (414) 351-7100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3036 | Other | CO | LPC |
| 4165-125 | Other | WI | LPC |
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 |
|---|---|---|---|
| 4165-125 | WI | MD | Mental Health Counselor |
| 3036 | CO | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280275200000",
"number": "1891882429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6980 N PORT WASHINGTON RD",
"address_2": "202",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532173900",
"telephone_number": "414-351-7100",
"fax_number": "414-247-4082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6980 N PORT WASHINGTON RD",
"address_2": "202",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532173900",
"telephone_number": "414-351-7100",
"fax_number": "414-247-4082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASSEN",
"first_name": "LANA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-06",
"last_updated": "2010-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CO",
"license": "3036",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WI",
"license": "4165-125",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC",
"identifier": "3036",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC",
"identifier": "4165-125",
"state": "WI"
}
],
"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 Jul 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.