Individual provider Active NPI

William D Frazer-Collins, LPC

  • Professional Counselor
  • Brookfield, WI
National Provider Identifier
1346514841
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5409-125 Issued in WI
Practice address
19115 W Capitol Dr
Ste 117
Brookfield, WI 53045-2754
Phone
(262) 781-0240
Fax
(262) 373-0148
NPI assigned
Mar 1, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5409-125 WI Primary

Addresses

Primary practice location

19115 W Capitol Dr
Ste 117
Brookfield, WI 53045-2754

Mailing address

19115 W Capitol Dr
Ste 117
Brookfield, WI 53045-2754
Phone (262) 781-0240

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
I20240514003758 WI Practitioner - Mental Health Counselor 3375984909 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5409-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Abg Wellness Group Inc CurrentSince Mar 7, 2024 Accepting new patients
Healing Corner, LLC PastSince Aug 31, 2010 Accepting new patients

Locations

11414 W Park Pl
Ste 202
Milwaukee, WI 53224
Phone (414) 292-7060

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": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1346514841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19115 W CAPITOL DR",
            "address_2": "STE 117",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452754",
            "telephone_number": "262-781-0240",
            "fax_number": "262-373-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19115 W CAPITOL DR",
            "address_2": "STE 117",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452754",
            "telephone_number": "262-781-0240",
            "fax_number": "262-373-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZER-COLLINS",
        "first_name": "WILLIAM",
        "middle_name": "D",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-01",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5409-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.