Evangeline M Suquet, MAC, CSAC, LPC, CSIT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

15705-132 Issued in WI

Practice address

W9850 Airport Road
Black River Falls, WI 54615

Phone

(715) 284-9851

Fax

(715) 284-3434

NPI assigned

Mar 5, 2009

Last updated

Oct 20, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2007

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ascension NE Wisconsin, Inc

  dba Ascension NE Wisconsin-St Elizabeth Campus

  • General Acute Care Hospital
  • Appleton, WI
  • NPI 1407803638
  Medicare reassignment

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

{
    "created_epoch": "1236211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1912147828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918",
            "address_2": "W9850 AIRPORT ROAD",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "54615",
            "telephone_number": "715-284-9851",
            "fax_number": "715-284-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W9850 AIRPORT ROAD",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "54615",
            "telephone_number": "715-284-9851",
            "fax_number": "715-284-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUQUET",
        "first_name": "EVANGELINE",
        "middle_name": "M",
        "credential": "MAC, CSAC, LPC, CSIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-05",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15705-132",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "5231-125",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jon P Stowe, DC
• Alicia Marie Strong
• Heather Struensee
• Eric Matthew Stugen, RN
• James Michael Suchanek, EMT,PERSONALTRAINER
• Jesse John Susa, MD
• Nathan A Swan, DPT
• Symphony Respiratory Services (Golden Care)
• James L Szymanski, PT
• Jess M Thill, RN

• Addiction (Substance Use Disorder) Counselor in Black River Falls, WI
• Providers in Black River Falls, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.