Individual provider Active NPI

Lana M Nassen, LPC

  • Mental Health Counselor
  • Glendale, WI
National Provider Identifier
1891882429
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4165-125 Issued in WI
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

Updated by the provider on Jul 28, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
3036OtherCOLPC
4165-125OtherWILPC

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
4165-125WIMDMental Health Counselor
3036COMDMassage 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.

Verify at the official NPI Registry.