JUDITH GERALYN TEGGE (NPI# 1700222338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700222338 |
| Entity Type | Individual |
| Full Name | JUDITH GERALYN TEGGE |
| Other Name | MISS JUDITH GERALYN HEEZEN |
| Credential | LPC |
| Practice Address |
5555 N Port Washington Rd Suite 200 Glendale WI 53217-4929 |
| Practice Telephone | 2627891191 |
| Practice Fax Number | 4149677965 |
| Mailing Telephone | 2627891191 |
| Mailing Fax Number | 4149677965 |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2013-05-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42170300 | 05 | |
| WI | GROUP MEDICARE (P-TAN) MILWAUKEE COUNTY | 000-088745 | 01 |
| Street Address |
5555 N PORT WASHINGTON RD SUITE 200 |
| City | GLENDALE |
| State | WI |
| Zip Code | 53217-4929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306878368 | Jeffrey Lewis Polczinski | Psychologist | 5555 N Port Washington Rd, Suite 304, Glendale, WI 53217 | 2006-07-07 |
| 1831797224 | Jazmin Christine Binns | Counselor | 5555 N Port Washington Rd, Glendale, WI 53217-4929 | 2020-10-16 |
| 1164738183 | Julie Rupena-reynolds | Counselor | 5555 N Port Washington Rd, 200, Glendale, WI 53217-4929 | 2010-08-27 |
| 1124291976 | Jeffrey L Polczinski Psyd LLC | Psychologist | 5555 N Port Washington Rd, Suite 304, Glendale, WI 53217 | 2008-04-11 |
| 1033207386 | Caroline G Schmidt | Psychologist | 5555 N Port Washington Rd, Suite 200, Glendale, WI 53217-4929 | 2006-10-11 |
| 1114020773 | Bruce Andrew Semon | Psychiatry & Neurology | 5555 N Port Washington Rd, #200, Glendale, WI 53217-4927 | 2006-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922632587 | Jasmine Dockery | Pharmacist | 5400 N Port Washington, Glendale, WI 53217 | 2020-02-23 |
| 1174017339 | North Lakes Nursing Home Health Care Agency LLC | Home Health | 225 E Fairmount Ave, Milwaukee, WI 53217 | 2018-06-20 |
| 1083140289 | Miriah Ann King, Ms, Lpc | Counselor | 7805 North Boyd Way, Fox Point, WI 53217 | 2017-05-08 |
| 1245783067 | Lakesha L Jones | Counselor | 5235 N Ironwood Rd, Glendale, WI 53217 | 2016-07-28 |
| 1750783312 | Ibrahim S Abouzeid | Specialist/Technologist, Other | 333 W Brown Deer Road, #240, Milwaukee, WI 53217 | 2014-09-25 |
| 1255733598 | Victoria Gorodetsky | Pharmacist | 229 W Indian Creek Ct, Milwaukee, WI 53217 | 2014-09-18 |
| 1174800049 | John Herman Esser | Internal Medicine | 1050 W Acacia Rd, Milwaukee, WI 53217 | 2011-11-07 |
| 1710298351 | Leann M Harman | Physical Therapist | 5333 N Port Washington Rd Ste B, Glendale, WI 53217 | 2010-06-29 |
| 1306012455 | Emily Marie Gallagher | Speech-Language Pathologist | 6700 N. Port Washington Road, Milwaukee, WI 53217 | 2008-05-07 |
| 1164625455 | Mary Catherine Enderlin | Psychologist | 6110 N Port Washington Road, The Cambridge Group, Glendale, WI 53217 | 2007-06-06 |
| Find all providers in zip 53217 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
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| 1609483825 | Wisemind Sober Living and Treatment, LLC | Counselor | 5755 W Irma Ln, Glendale, AZ 85308-9178 | 2020-09-30 |
| 1740814664 | Maryjoy C Kearns | Counselor | 7400 W Arrowhead Clubhouse Dr Apt 2036, Glendale, AZ 85308-8825 | 2020-02-29 |
| 1366089997 | Lilit Ginosyan Hayrapetyan | Counselor | 401 N Brand Blvd Ste 366, Glendale, CA 91203-4427 | 2019-12-02 |
| 1104473552 | Sabrina Laporta | Counselor | 7037 65th Pl Apt 1r, Glendale, NY 11385-6426 | 2019-08-21 |
| 1760042667 | Arineh Ohanian | Counselor | 1022 Elm Ave, Glendale, CA 91201-3424 | 2019-06-13 |
| 1467010801 | Rebecca Bautista | Counselor | 223 North Jackson Street, Glendale, CA 91206 | 2019-05-31 |
| 1093275018 | Heather Marie Ford | Counselor | 7303 W Robin Ln, Glendale, AZ 85310-5653 | 2019-03-25 |
| 1023585742 | Center for Couples Therapy, Pllc | Counselor | 18205 N 51st Ave, Ste 113, Glendale, AZ 85308 | 2018-10-31 |
| 1992209431 | Jessica Ann Van Leer | Counselor | 17505 N 79th Ave Ste 410, Glendale, AZ 85308-8732 | 2018-03-20 |
| Find all providers in GLENDALE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.