Individual provider Active NPI

Mark Steven Fossie, MS, LMFT, CSAC, ICS

  • Marriage & Family Therapist
  • Milwaukee, WI
National Provider Identifier
1114145612
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
460-124 Issued in WI
Practice address
2821 N 4TH St
516
Milwaukee, WI 53212-2362
Phone
(414) 263-6000
Fax
(414) 263-2270
NPI assigned
Apr 23, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 14971-132 WI
Social Worker 104100000X 402 WI
Marriage & Family Therapist 106H00000X 460-124 WI Primary

Addresses

Primary practice location

2821 N 4TH St
516
Milwaukee, WI 53212-2362

Mailing address

2821 N 4TH St
516
Milwaukee, WI 53212-2362
Phone (414) 263-6000

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
I20240329001367 WI Practitioner - Marriage and Family Therapist 8325362668 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14971-132WIMDAddiction (Substance Use Disorder) Counselor
402WIMDSocial Worker
460-124WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
M & S Clinical Services, Inc Current Accepting new patients
The Power of Change Addiction (Substance Use Disorder) CurrentSince Feb 25, 2024 Accepting new patients
Westcare Wisconsin, Inc PastSince Mar 20, 2022 Accepting new patients

Locations

2821 N Vel R Phillips Ave
Ste 131
Milwaukee, WI 53212
Phone (414) 374-8787

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, 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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1114145612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 N 4TH ST",
            "address_2": "516",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122362",
            "telephone_number": "414-263-6000",
            "fax_number": "414-263-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 N 4TH ST",
            "address_2": "516",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532122362",
            "telephone_number": "414-263-6000",
            "fax_number": "414-263-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSSIE",
        "first_name": "MARK",
        "middle_name": "STEVEN",
        "name_prefix": "Mr.",
        "credential": "MS, LMFT, CSAC, ICS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "14971-132",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "402",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "460-124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.