John Barajas, LPC, SAC-IT
Individual provider Active NPI Professional Counselor · Appleton, WI
NPI 1003484478 · NPPES record last updated Feb 3, 2025
Key facts
- NPI
- 1003484478
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 10935-123 (WI)
- Practice address
- 4650 W Spencer St
Appleton, WI 54914-9106 - Phone
- (920) 903-1060
- Fax
- (920) 903-1060
- NPI assigned
- Jun 14, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- 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.
Practice addresses (Care Compare)
4650 W Spencer St
Appleton, WI 54914-9106
Phone (920) 903-1060
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240416000672 | WI | Practitioner - Mental Health Counselor | 6901245596 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19327-130 | WI | MD | Addiction (Substance Use Disorder) Counselor |
| 10935-123 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| US 2 Behavioral Health Care Inc | Professional | Current |
Accepting new patients |
Locations
4650 W Spencer St
Appleton, WI 54914
Phone (920) 903-1060
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 19327-130 | WI | |
| Professional Counselor | 101YP2500X | 10935-123 | WI | Yes |
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
Other providers in Appleton, WI
- Sheila May Banda
- Sankalpa Bandi
- Animesh Banerjea
- Gloria Jean Bannasch
- Avi Bar-Lev
- Rebecca Barbosa
- Richard T Bares
- James R Bargenquast
- Shannon Nicole Barker
- Lauren K Barlow
All providers in Appleton, WI · Professional Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.