SUSAN M MATZKE MS NPI 1689640401

NPI Information

NPI: 1689640401
Provider Name: SUSAN M MATZKE, MS
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
1 S MAIN ST
JANESVILLE, WI
ZIP 53545
Phone: (608) 757-0404
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Susan M Matzke, MS is a mental health counselor in Janesville, WI. Susan M Matzke, MS NPI is 1689640401. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1 S MAIN ST
JANESVILLE, WI
ZIP 53545-922
Phone: (608) 757-0404
Fax: (608) 757-2319

The enumeration date for this NPI number is 2/23/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	463-125	WISCONSIN	Yes
2	1041C0700X	Social Worker	Clinical	3327-123	WISCONSIN	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	39196700	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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