Individual provider Active NPI

Jonathan W Friske, SAC-IT, BA

  • Addiction (Substance Use Disorder) Counselor
  • Madison, WI
National Provider Identifier
1295567048
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
20318-130 Issued in WI
Practice address
5109 World Dairy Dr
Madison, WI 53718-3807
Phone
(608) 242-0220
Fax
(608) 242-1166
NPI assigned
Aug 19, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 20318-130 WI Primary

Addresses

Primary practice location

5109 World Dairy Dr
Madison, WI 53718-3807

Mailing address

5109 World Dairy Dr
Madison, WI 53718-3807
Phone (608) 242-0220

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
20318-130WIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1295567048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5109 WORLD DAIRY DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537183807",
            "telephone_number": "608-242-0220",
            "fax_number": "608-242-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5109 WORLD DAIRY DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537183807",
            "telephone_number": "608-242-0220",
            "fax_number": "608-242-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRISKE",
        "first_name": "JONATHAN",
        "middle_name": "W",
        "credential": "SAC-IT, BA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "20318-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.