Individual provider Active NPI

Richard R Brendle

  • Professional Counselor
  • Brookfield, WI
National Provider Identifier
1093382202
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
13035 W Bluemound Rd Ste 100
Brookfield, WI 53005-8001
Phone
(920) 245-8379
NPI assigned
Jun 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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 Primary

Addresses

Primary practice location

13035 W Bluemound Rd Ste 100
Brookfield, WI 53005-8001

Mailing address

13035 W Bluemound Rd Ste 100
Brookfield, WI 53005-8001
Phone (920) 245-8379

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
I20250820002930 WI Practitioner - Mental Health Counselor 8921508433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life-Span Psychological Services, LLCGroup PAC ID 5991859258, 8 clinicians

Practice addresses (Care Compare)

13035 W Bluemound Rd
Suite 100
Brookfield, WI 53005-8001
Phone (262) 784-1121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Life-Span Psychological Services, LLC Professional CurrentSince Aug 8, 2025 Accepting new patients
The Matthew Project, Inc. Past Accepting new patients

Locations

13035 W Bluemound Rd
Ste 1
Brookfield, WI 53005

13035 W Bluemound Rd
Ste 100
Brookfield, WI 53005
Phone (262) 223-6125

448 S Military Rd
Ste A
Fond du Lac, WI 54935

384 W Sumner St
Hartford, WI 53027
Phone (262) 223-6125

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1093382202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13035 W BLUEMOUND RD STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530058001",
            "telephone_number": "920-245-8379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13035 W BLUEMOUND RD STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530058001",
            "telephone_number": "920-245-8379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENDLE",
        "first_name": "RICHARD",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.