Bradley Ray Hawbecker, SAC 15654-131

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

15654-131 Issued in WI

Practice address

2240 Praire Ave
10
Beloit, WI 53511-2940

Phone

(608) 361-7200

Fax

(608) 361-7201

NPI assigned

Jan 30, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1235316381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 N GRANDVIEW BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531886105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 PRAIRE AVE",
            "address_2": "10",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535112940",
            "telephone_number": "608-361-7200",
            "fax_number": "608-361-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWBECKER",
        "first_name": "BRADLEY",
        "middle_name": "RAY",
        "credential": "SAC 15654-131",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-30",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15654-131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42247900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Beverly Ann Heinz

• Addiction (Substance Use Disorder) Counselor in Beloit, WI
• Providers in Beloit, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.