Individual provider Active NPI

Jillian Rotzenberg, LPC

  • Professional Counselor
  • Appleton, WI
National Provider Identifier
1336658285
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7745-125 Issued in WI
Practice address
2323 W Everett St
Appleton, WI 54914-4749
Phone
(920) 560-4525
Fax
(920) 560-6618
NPI assigned
Sep 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X 7745-125 WI Primary

Addresses

Primary practice location

2323 W Everett St
Appleton, WI 54914-4749

Mailing address

2323 W Everett St
Appleton, WI 54914-4749
Phone (920) 560-4525

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
I20240113000616 WI Practitioner - Marriage and Family Therapist 3476866484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
GJB Health Services, LLCGroup PAC ID 5496068405, 2 clinicians

Practice addresses (Care Compare)

2323 W Everett St
Appleton, WI 54914-4749
Phone (920) 560-4525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7745-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
GJB Eeg Services, SC CurrentSince Jul 1, 2022 Accepting new patients

Locations

711 N Lynndale Dr
Ste 1A
Appleton, WI 54914
Phone (920) 217-7861

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22083/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1336658285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 W EVERETT ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549144749",
            "telephone_number": "920-560-4525",
            "fax_number": "920-560-6618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 W EVERETT ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549144749",
            "telephone_number": "920-560-4525",
            "fax_number": "920-560-6618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTZENBERG",
        "first_name": "JILLIAN",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-22",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "7745-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.