Rebecca A. Guynn

Primary specialty

Social WorkerTaxonomy code 104100000X

License

127930-121 Issued in IL

Practice address

459 E 1St St
Fond Du Lac, WI 54935-4505

Phone

(920) 929-3579

Fax

(920) 929-3129

NPI assigned

Apr 28, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Rebecca A. Fries Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Fond Du Lac County

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fond Du Lac, WI
  • NPI 1053458935
  NPD (past)

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1114218831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 E 1ST ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354505",
            "telephone_number": "920-929-3500",
            "fax_number": "920-929-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 E 1ST ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354505",
            "telephone_number": "920-929-3579",
            "fax_number": "920-929-3129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUYNN",
        "first_name": "REBECCA",
        "middle_name": "A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-28",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "127930-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "FRIES",
            "middle_name": "A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aditi Gupta
• Sameer Gupta, MD
• Sarah J Guse, NP
• Josiah R Gutierrez Jr., LPN
• Barbara R Guy, AP, NP
• Jessica L Habeck, DNP, APNP, FNP-BC
• Gretchen Catherine Hafemeister, COTA
• Kelly Marie Hagner, APNP
• Amber J Hahn, PT
• Michelle Lynn Halfman, MS CCC SLP

• Social Worker in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; 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.