Matthew Banas

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

750 Veterans Pkwy Unit 100
Lake Geneva, WI 53147-4950

Phone

(262) 248-7942

NPI assigned

Sep 10, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Lake Geneva Wellness Clinic LLC

  • Clinical Psychologist
  • Lake Geneva, WI
  • NPI 1003845181
  NPD
• Clinical Psychology Associates, LLC

  dba Clinical Psychology Associates

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Burlington, WI
  • NPI 1619156502
  NPD (past)

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1093320608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40723 93RD ST",
            "city": "GENOA CITY",
            "state": "WI",
            "postal_code": "531281291",
            "telephone_number": "219-476-5863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 VETERANS PKWY UNIT 100",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474950",
            "telephone_number": "262-248-7942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANAS",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-10",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Bader, ATC, LAT
• John Ellsworth Baldwin, RPH
• Balistreri & Associates Physical Therapy
• Suzanne Balistreri-Roden, P.T.
• Anshul B. Bamrolia, MD
• Melisa Barber
• Sally Bardin, LPC
• Ellen Grace Barnstable, MD
• Megan Batz
• Erin Bauman, NURSE PRACTITIONER

• Mental Health Counselor in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.