Lynnellen Proeber, SAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

16135-131 Issued in WI

Practice address

1610 Miller Park Way
West Milwaukee, WI 53214-3604

Phone

(414) 672-3801

NPI assigned

Feb 27, 2017

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

Other names 1

• Ms. Lynnellen Proeber Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1922548817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 MILLER PARK WAY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532143604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 MILLER PARK WAY",
            "city": "WEST MILWAUKEE",
            "state": "WI",
            "postal_code": "532143604",
            "telephone_number": "414-672-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROEBER",
        "first_name": "LYNNELLEN",
        "credential": "SAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16794-130",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16135-131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNNELLEN",
            "last_name": "PROEBER",
            "prefix": "MS.",
            "credential": "SAC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Zachary Peloquin
• Julie Pendergast, RN
• Cynthia Perea Rodriguez, RN
• Ajit V Pillai, DMD
• Corey A Pleas, LPN
• Quality Addiction Management
• Annettte L. Radant, LPN
• Nina Rakowsky
• Stephanie R Reeves, RN
• Nicole Marie Reise, LPN

• All providers in West Milwaukee, WI
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.