Individual provider Active NPI

Jeanne M Brand, LPC

  • Mental Health Counselor
  • Rice Lake, WI
National Provider Identifier
1396808127
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3659-125 Issued in WI
Practice address
1035 N Main St
Rice Lake, WI 54868-1260
Phone
(715) 234-4313
Fax
(715) 736-0194
NPI assigned
Dec 19, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3659-125 WI Primary

Addresses

Primary practice location

1035 N Main St
Rice Lake, WI 54868-1260

Mailing address

1035 N Main St
Rice Lake, WI 54868-1260
Phone (715) 234-4313

Other identifiers 1

IdentifierTypeStateIssuer
43591500MedicaidWI

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
3659-125WIMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1396808127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 N MAIN ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548681260",
            "telephone_number": "715-234-4313",
            "fax_number": "715-736-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 N MAIN ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548681260",
            "telephone_number": "715-234-4313",
            "fax_number": "715-736-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAND",
        "first_name": "JEANNE",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "3659-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43591500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rice Lake, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.