Individual provider Active NPI

John Barajas, LPC, SAC-IT

  • Professional Counselor
  • Appleton, WI
National Provider Identifier
1003484478
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
10935-123 Issued in WI
Practice address
4650 W Spencer St
Appleton, WI 54914-9106
Phone
(920) 903-1060
Fax
(920) 903-1060
NPI assigned
Jun 14, 2021
Last updated
Feb 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 19327-130 WI
Professional Counselor 101YP2500X 10935-123 WI Primary

Addresses

Primary practice location

4650 W Spencer St
Appleton, WI 54914-9106

Mailing address

4650 W Spencer St
Appleton, WI 54914-9106
Phone (920) 903-1060

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
I20240416000672 WI Practitioner - Mental Health Counselor 6901245596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
US 2 Behavioral Health Care Inc.Group PAC ID 1557691151, 5 clinicians

Practice addresses (Care Compare)

4650 W Spencer St
Appleton, WI 54914-9106
Phone (920) 903-1060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19327-130WIMDAddiction (Substance Use Disorder) Counselor
10935-123WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
US 2 Behavioral Health Care Inc Professional CurrentSince Feb 3, 2025 Accepting new patients

Locations

4650 W Spencer St
Appleton, WI 54914
Phone (920) 903-1060

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1003484478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 W SPENCER ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549149106",
            "telephone_number": "920-903-1060",
            "fax_number": "920-903-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W SPENCER ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549149106",
            "telephone_number": "920-903-1060",
            "fax_number": "920-903-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARAJAS",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "LPC, SAC-IT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-14",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "19327-130",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "10935-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.