Individual provider Active NPI

Cassie M Graveen, LPC-IT, MSAT

  • Mental Health Counselor
  • Wausau, WI
National Provider Identifier
1134630965
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3311-226 Issued in WI
Practice address
501 Division St
Wausau, WI 54403-6206
Phone
(715) 301-0667
NPI assigned
Oct 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3311-226 WI Primary
Professional Counselor 101YP2500X 3311 WI

Addresses

Primary practice location

501 Division St
Wausau, WI 54403-6206

Mailing address

R5743 Meridian Rd
Athens, WI 54411-9317
Phone (414) 578-7253

Other practice location 1

1100 Lake View Dr
Wausau, WI 54403-6799
Phone (715) 848-4600

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
I20240227002751 WI Practitioner - Mental Health Counselor 2961847124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2400 Marshall St
Suite a
Wausau, WI 54403-6738
Phone (715) 848-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3311-226WIMDMental Health Counselor
3311WIMDNurse Practitioner
7973WIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Human Services Board Serving North Central Heatlh Care Facility CurrentSince Jan 1, 2024 Accepting new patients
Human Services Board Serving North Central Health Care Facility Current Accepting new patients
Human Services Board Serving North Central Health Care Facility CurrentSince Jan 1, 2024 Accepting new patients
The Caring Tree LLC Past Accepting new patients

Locations

1225 Langlade Rd
Antigo, WI 54409
Phone (715) 623-2394

607 N Sales St
Ste 309
Merrill, WI 54452
Phone (715) 536-9482

2400 Marshall St
Ste A
Wausau, WI 54403
Phone (715) 848-4600

1100 Lake View Dr
Wausau, WI 54403
Phone (715) 848-4454

Organizations & group practices 4

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": "1508371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1134630965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "R5743 MERIDIAN RD",
            "city": "ATHENS",
            "state": "WI",
            "postal_code": "544119317",
            "telephone_number": "414-578-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 DIVISION ST",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544036206",
            "telephone_number": "715-301-0667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Lake View Dr",
            "address_purpose": "LOCATION",
            "city": "Wausau",
            "state": "WI",
            "postal_code": "544036799",
            "country_code": "US",
            "telephone_number": "715-848-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAVEEN",
        "first_name": "CASSIE",
        "middle_name": "M",
        "credential": "LPC-IT, MSAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-19",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "3311-226",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3311",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.