NPIMap

Organization Active NPI

County of Brown

Doing business as Brown County Community Treatment Center - CCS Non billing

  • Community/Behavioral Health Agency
  • Green Bay, WI
National Provider Identifier
1396811204
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
2615 Issued in WI
Legal business name
COUNTY OF BROWN
Doing business as
Brown County Community Treatment Center - CCS Non billing
Practice address
3150 Gershwin Drive
Green Bay, WI 54311-5859
Phone
(920) 391-4839
Fax
(920) 391-4870
NPI assigned
Nov 24, 2006
Last updated
Feb 11, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTY OF BROWNAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

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

Authorized official

Name
Kevin Lunog, MS, LCSW, CADCIII
Title
Clinical Support Service Coor
Phone
(920) 391-6959

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 2615 WI Primary

Addresses

Primary practice location

3150 Gershwin Drive
Green Bay, WI 54311-5859

Mailing address

3150 Gershwin Drive
Green Bay, WI 54311-5859
Phone (920) 391-4839

Other identifiers 1

IdentifierTypeStateIssuer
41761700MedicaidWI

Other names 1

  • Brown County Community Treatment Center - CCS Non billing Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Brown Co HLTH Dept19 organizations share this tax ID, including this one
Part of
Brown Co HLTH Dept

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1396811204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 GERSHWIN DRIVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115859",
            "telephone_number": "920-391-4839",
            "fax_number": "920-391-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 GERSHWIN DRIVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115859",
            "telephone_number": "920-391-4839",
            "fax_number": "920-391-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF BROWN",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF BROWN",
        "enumeration_date": "2006-11-24",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "LUNOG",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CLINICAL SUPPORT SERVICE COOR",
        "authorized_official_telephone_number": "920-391-6959",
        "authorized_official_credential": "MS, LCSW, CADCIII"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "2615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41761700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brown County Community Treatment Center - CCS Non billing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; 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.