Individual provider Active NPI

Bryan Frazier, LPC-IT

  • Professional Counselor
  • Madison, WI
National Provider Identifier
1114681848
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5086-226 Issued in WI
Practice address
49 Kessel CT
Madison, WI 53711-6200
Phone
(608) 280-2700
NPI assigned
Oct 28, 2021
Last updated
Oct 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 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 5086-226 WI Primary

Addresses

Primary practice location

49 Kessel CT
Madison, WI 53711-6200

Mailing address

25 Kessel CT Ste 105
Madison, WI 53711-6227
Phone (608) 280-2700

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
I20240402003256 WI Practitioner - Mental Health Counselor 3779921325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3125 Main St
Stevens Point, WI 54481-3269
Phone (920) 787-5514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5086-226WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de Los Campesinos, Inc CurrentSince Mar 25, 2024 Accepting new patients
La Clinica de Los Campesinos, Inc CurrentSince Mar 25, 2024 Accepting new patients
Journey Mental Health Center, Inc. CurrentSince Oct 31, 2021 Accepting new patients

Locations

1701 N Spring St
Beaver Dam, WI 53916
Phone (920) 644-0317

302 W Lake St
Friendship, WI 53934
Phone (608) 339-3326

25 Kessel Ct
Ste 105
Madison, WI 53711
Phone (608) 280-2636

49 Kessel Ct
Madison, WI 53711
Phone (608) 280-2510

3125 Main St
Stevens Point, WI 54481
Phone (715) 254-9072

400 S Townline Rd
Wautoma, WI 54982
Phone (920) 647-8984

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": "1635379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1114681848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 KESSEL CT STE 105",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537116227",
            "telephone_number": "608-280-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 KESSEL CT",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537116200",
            "telephone_number": "608-280-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "BRYAN",
        "credential": "LPC-IT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5086-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.