Elijah L Freeman, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

10696 Issued in WI

Practice address

2500 E Enterprise Ave Ste B
Appleton, WI 54913-8556

Phone

(920) 416-8577

Fax

(920) 416-8581

NPI assigned

Jan 11, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nystrom and Associates Counseling Wi SCGroup PAC ID 1052729464, 108 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Nystrom & Associates Counseling Wi., S.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • La Crosse, WI
  • NPI 1659977866
  Medicare reassignment Care Compare group NPD
• Nystrom & Associates Counseling Wi., S.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fargo, ND
  • NPI 1104549047
  NPD
• Family Services of Northeast Wisconsin Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Menasha, WI
  • NPI 1275525925
  NPD (past)
• Family Services of Northeast Wisconsin Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1467453167
  NPD (past)

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1366193385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW STE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121789",
            "telephone_number": "651-628-9566",
            "fax_number": "651-628-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E ENTERPRISE AVE STE B",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138556",
            "telephone_number": "920-416-8577",
            "fax_number": "920-416-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "ELIJAH",
        "middle_name": "L",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-11",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "2804",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "5175",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "10696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Frank, RN
• Nichol M Frank, PA-C
• Torri Franz, APNP
• Larissa Fravel
• Freedomwealthmanagement
• Jonathan D Freeman, DPT
• Kerry Sara Freeman, RPH
• Nicholas Scott-Patrick Freeman, D.O.
• Passion Freeman
• Patricia Freeman

• Professional Counselor in Appleton, WI
• Providers in Appleton, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.