Individual provider Active NPI

Deia Lawrence

  • Professional Counselor
  • Milwaukee, WI
National Provider Identifier
1922475466
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5467125 Issued in WI
Practice address
3312 N 46TH St
Milwaukee, WI 53216-3331
Phone
(414) 350-3641
NPI assigned
Sep 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5467125 WI Primary

Addresses

Primary practice location

3312 N 46TH St
Milwaukee, WI 53216-3331

Mailing address

3312 N 46TH St
Milwaukee, WI 53216-3331

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240827000406 WI Practitioner - Mental Health Counselor 0941749675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Abg Wellness Group IncGroup PAC ID 0345536785, 16 clinicians

Practice addresses (Care Compare)

11414 W Park PL
Suite 202
Milwaukee, WI 53224-3500
Phone (414) 292-7060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5467125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Abg Wellness Group Inc CurrentSince Aug 2, 2024 Accepting new patients

Locations

11414 W Park Pl
Ste 202
Milwaukee, WI 53224
Phone (414) 292-7060

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1922475466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3312 N 46TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532163331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 N 46TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532163331",
            "telephone_number": "414-350-3641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "DEIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-01",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5467125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.