Individual provider Active NPI

Clayton Edward Abts, MS LPC

  • Professional Counselor
  • Green Bay, WI
National Provider Identifier
1043305154
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3754125 Issued in WI
Practice address
300 Crooks Street
Green Bay, WI 54301
Phone
(920) 436-6800
Fax
(920) 432-5966
NPI assigned
Oct 4, 2006
Last updated
Apr 20, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3754125 WI Primary

Addresses

Primary practice location

300 Crooks Street
Green Bay, WI 54301

Mailing address

PO Box 22308
300 Crooks Street
Green Bay, WI 54305-2308
Phone (920) 436-6800

Other identifiers 1

IdentifierTypeStateIssuer
40946300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3754125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Services of Northeast Wisconsin Inc Past Accepting new patients
Family Services of Northeast Wisconsin Inc Past Accepting new patients

Organizations & group practices 2

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240185600000",
    "number": "1043305154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22308",
            "address_2": "300 CROOKS STREET",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052308",
            "telephone_number": "920-436-6800",
            "fax_number": "920-432-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CROOKS STREET",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54301",
            "telephone_number": "920-436-6800",
            "fax_number": "920-432-5966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABTS",
        "first_name": "CLAYTON",
        "middle_name": "EDWARD",
        "credential": "MS LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2009-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3754125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40946300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.