Individual provider Active NPI

William Vansusteren, MS, LPC-IT

  • Mental Health Counselor
  • Beaver Dam, WI
National Provider Identifier
1063995132
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4066-226 Issued in WI
Practice address
111 Warren St Ste 2
Beaver Dam, WI 53916-3084
Phone
(920) 219-4440
NPI assigned
Sep 13, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4066-226 WI Primary

Addresses

Primary practice location

111 Warren St Ste 2
Beaver Dam, WI 53916-3084

Mailing address

111 Warren St
Beaver Dam, WI 53916-3084
Phone (920) 219-4440

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
I20240115000663 WI Practitioner - Mental Health Counselor 7719339860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
University of Wisconsin School of Medicine, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Alarus Healthcare LLCGroup PAC ID 8022231026, 11 clinicians

Practice addresses (Care Compare)

1971 Washington St
Suite 200
Grafton, WI 53024-2125
Phone (262) 377-6276

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4066-226WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alarus Healthcare, LLC CurrentSince Jan 1, 2024 Accepting new patients
Living for Liberation CurrentSince Dec 10, 2023 Accepting new patients
Alarus Home Health LLC PastSince Jan 1, 2024 Accepting new patients

Locations

111 Warren St
Beaver Dam, WI 53916
Phone (262) 224-7721

111 Warren St
Ste 2
Beaver Dam, WI 53916
Phone (920) 216-4440

1971 Washington St
Ste 200
Grafton, WI 53024
Phone (262) 377-6276

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1063995132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WARREN ST",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163084",
            "telephone_number": "920-219-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WARREN ST STE 2",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539163084",
            "telephone_number": "920-219-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANSUSTEREN",
        "first_name": "WILLIAM",
        "credential": "MS, LPC-IT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-13",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "4066-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaver Dam, WI

Sources for this page

Verify at the official NPI Registry.