Individual provider Active NPI

Sean B Jones, LPC

  • Professional Counselor
  • Waukesha, WI
National Provider Identifier
1215237607
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2996-125 Issued in WI
Practice address
2607 N Grandview Blvd Ste 160G
Waukesha, WI 53188-1686
Phone
(262) 290-3337
NPI assigned
Nov 1, 2010
Last updated
Sep 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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 12639-131 WI
Professional Counselor 101YP2500X 2996125 WI
Professional Counselor 101YP2500X 2996-125 WI Primary

Addresses

Primary practice location

2607 N Grandview Blvd Ste 160G
Waukesha, WI 53188-1686

Mailing address

W288S3848 Wern Farm Cir E
Waukesha, WI 53189-8919
Phone (145) 730-2004

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sean@execcounseling.com Direct

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

LicenseStateTypeSpecialty
12639-131WIMDAddiction (Substance Use Disorder) Counselor
2996-125WIMDProfessional Counselor
2996125WIMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1215237607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W288S3848 WERN FARM CIR E",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531898919",
            "telephone_number": "145-730-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 N GRANDVIEW BLVD STE 160G",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881686",
            "telephone_number": "262-290-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "SEAN",
        "middle_name": "B",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "12639-131",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "2996125",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "2996-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sean@execcounseling.com",
            "affiliation": "N",
            "endpointDescription": "E-Mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2607 N Grandview Blvd Ste 160G",
            "city": "Waukesha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531881686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.