Active NPI
Brian Fobian, CADC III
- Addiction (Substance Use Disorder) Counselor
- Menomonee Falls, WI
National Provider Identifier
1114948460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 10747
- Practice address
- N84W15787 Menomonee Ave
Suite 6
Menomonee Falls, WI 53051-3081 - Phone
- (262) 255-5571
- Fax
- (262) 255-5581
- NPI assigned
- Jul 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 10747 | WI | Primary |
Addresses
Primary practice location
N84W15787 Menomonee Ave
Suite 6
Menomonee Falls, WI 53051-3081
Mailing address
285 N Janacek Rd
Brookfield, WI 53045-6102
Phone (262) 641-9050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39377600 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10747 | WI | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196380800000",
"number": "1114948460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "285 N JANACEK RD",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530456102",
"telephone_number": "262-641-9050",
"fax_number": "262-641-9126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "N84W15787 MENOMONEE AVE",
"address_2": "SUITE 6",
"city": "MENOMONEE FALLS",
"state": "WI",
"postal_code": "530513081",
"telephone_number": "262-255-5571",
"fax_number": "262-255-5581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOBIAN",
"first_name": "BRIAN",
"credential": "CADC III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-22",
"last_updated": "2007-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "10747",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39377600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Menomonee Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.