MS. LARA SKYE TIKKANEN (NPI# 1689884686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689884686 |
| Entity Type | Individual |
| Full Name | MS. LARA SKYE TIKKANEN |
| Credential | LPC, CSAC |
| Practice Address |
6502 Grand Teton Plz Ste 102 Madison WI 53719-1047 |
| Mailing Address |
1334 Applegate Road Suite 101 Madison WI 53713-3184 |
| Practice Telephone | 6088277220 |
| Practice Fax Number | 6088277223 |
| Mailing Telephone | 6082211500 |
| Mailing Fax Number | 6082211515 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2019-02-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
5352-125 | WI | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
15459-132 | WI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | SAC-IT | 14277-130 | 01 |
| WI | LPC | 5352-125 | 01 |
| WI | CSAC | 15459-132 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1334 Applegate Rd, Madison, WI 53713 | 6082211500 | 6082211515 |
| Street Address |
6502 GRAND TETON PLZ STE 102 |
| City | MADISON |
| State | WI |
| Zip Code | 53719-1047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393395 | Joelle Wayer | Social Worker | 6502 Grand Teton Plz Ste 102, Madison, WI 53719-1047 | 2020-07-20 |
| 1962027342 | Mary E Smith | Counselor | 6502 Grand Teton Plz Ste 102, Madison, WI 53719-1047 | 2020-06-11 |
| 1164904991 | Lindsay A Jordan-zammuto | Social Worker | 6502 Grand Teton Plz Ste 102, Madison, WI 53719-1047 | 2018-08-29 |
| 1467933580 | Alena E Jensen | Social Worker | 6502 Grand Teton Plz Ste 102, Madison, WI 53719-1047 | 2018-08-27 |
| 1790278786 | Anne F D Stravinski | Social Worker | 6502 Grand Teton Plz Ste 102, Madison, WI 53719-1047 | 2018-06-13 |
| 1639671951 | Katherine Melissa Ainslie-wallace | Counselor | 6502 Grand Teton Plz Ste 102, Madison, WI 53719-1047 | 2018-03-02 |
| 1568986636 | Dia Matthews | Counselor | 6502 Grand Teton Plz Ste 102, Madison, WI 53719 | 2017-07-31 |
| 1427599786 | Rebecca Gennerman-schroeder | Counselor | 6502 Grand Teton Plz Ste 102, Madison, WI 53719-1047 | 2017-03-19 |
| 1851725626 | Lisa Beth Courchaine | Social Worker | 6502 Grand Teton Plz Ste 102, Madison, WI 53719-1047 | 2013-08-28 |
| 1467607259 | Christiam A Joseph | Social Worker | 6502 Grand Teton Plz Ste 102, Madison, WI 53719 | 2008-11-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689271801 | Jessica Seidel | Registered Nurse | 1015 Gammon Lane, Madison, WI 53719 | 2020-10-01 |
| 1376168989 | 360 Wellness LLC | Physical Therapist | 504 S Yellowstone Lane, Madison, WI 53719 | 2020-06-09 |
| 1932744067 | Sara Ruiz | Marriage & Family Therapist | Clock Tower Office Park, 6333 Odana Rd, #20, Madison, WI 53719 | 2019-11-13 |
| 1700436466 | David R. Gosling | Counselor | 702 South High Point Road #209, Madison, WI 53719 | 2019-09-16 |
| 1285289587 | Clifton Leo Davis Jr. | Counselor | 6417 O Dana Rd #5, Madison, WI 53719 | 2019-08-05 |
| 1679127278 | Akillah Jamillah Wali | Psychologist | 6417 Odana Rd Suite 5, Madison, WI 53719 | 2019-07-31 |
| 1689230211 | Brandy Georgecopeland | Marriage & Family Therapist | 6417 Odana Rd. Ste 5, Madison, WI 53719 | 2019-05-20 |
| 1275016826 | Kelsey Andersen | Physical Therapist | 504 S. Yellowstone Lane, Madison, WI 53719 | 2018-09-10 |
| 1740797190 | Catelyn Schwerke | Social Worker | 3848 Maple Grove Dr, Apt 307, Madison, WI 53719 | 2018-01-08 |
| 1922519008 | Mary Jane Cruz Delorme | Registered Nurse | 6831 Mader Dr. #210, #210, Madison, WI 53719 | 2017-10-17 |
| Find all providers in zip 53719 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578770 | Sunshine Holstein | Counselor | 467 Main St Fl 4, Madison, WV 25130-2200 | 2020-11-05 |
| 1619589538 | Pamela Peoples | Counselor | 1888 Main St Ste C-189, Madison, MS 39110-6337 | 2020-08-21 |
| 1487278404 | Gillian Vandien | Counselor | 2701 International Ln Ste 205, Madison, WI 53704-3126 | 2020-06-05 |
| 1134740210 | Amy C Nicholson | Counselor | 720 Hill St Ste 230, Madison, WI 53705-3539 | 2020-04-30 |
| 1902435308 | Jeffrey Joseph Bopp | Counselor | 518 Diving Hawk Trl, Madison, WI 53713-3380 | 2020-04-07 |
| 1881222313 | Christopher Gabriel Krell | Counselor | 133 Se Macon St, Madison, FL 32340-2986 | 2020-03-30 |
| 1174153381 | Kristine Fernerud | Counselor | 77 Legend Hill Rd, Madison, CT 06443-1877 | 2020-01-16 |
| 1568008886 | Avery Reven Kansteiner | Counselor | 105 Ski Court, Madison, WI 53713 | 2019-11-21 |
| 1124661996 | Lillian A Carroll | Counselor | 502 Pflaum Rd, Madison, WI 53716-2163 | 2019-10-23 |
| 1700436466 | David R. Gosling | Counselor | 702 South High Point Road #209, Madison, WI 53719 | 2019-09-16 |
| Find all providers in MADISON | ||||
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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.