Individual provider Active NPI

Connie Schrank, CSAC, ICS

  • Addiction (Substance Use Disorder) Counselor
  • Waukesha, WI
National Provider Identifier
1366032658
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
15142 Issued in WI
Practice address
2000 W Bluemound Rd
Waukesha, WI 53186-2787
Phone
(262) 202-6805
NPI assigned
Jan 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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 15142 WI Primary

Addresses

Primary practice location

2000 W Bluemound Rd
Waukesha, WI 53186-2787

Mailing address

2000 W Bluemound Rd
Waukesha, WI 53186-2787
Phone (262) 202-6805

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
15142WIMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1366032658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W BLUEMOUND RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531862787",
            "telephone_number": "262-202-6805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W BLUEMOUND RD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531862787",
            "telephone_number": "262-202-6805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRANK",
        "first_name": "CONNIE",
        "credential": "CSAC, ICS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Feb 1, 2021; 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.