Individual provider Active NPI

Michael Schachtner

  • Mental Health Counselor
  • Brookfield, WI
National Provider Identifier
1447769039
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
130830-121 Issued in WI
Practice address
12630 W North Ave BLDG E
Brookfield, WI 53005-4626
Phone
(262) 785-1008
NPI assigned
Sep 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 18243-130 WI
Mental Health Counselor 101YM0800X 130830-121 WI Primary

Addresses

Primary practice location

12630 W North Ave BLDG E
Brookfield, WI 53005-4626

Mailing address

147 W Ryan Rd
Oak Creek, WI 53154-4401
Phone (414) 343-6414

Other practice location 1

147 W Ryan Rd
Oak Creek, WI 53154-4401
Phone (414) 343-6414

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
I20180511002054 WI Practitioner - Clinical Social Worker 6800150210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christian Life Counseling LLCGroup PAC ID 8325046162, 10 clinicians

Practice addresses (Care Compare)

12630 W N Ave
Brookfield, WI 53005-4626

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18243-130WIMDAddiction (Substance Use Disorder) Counselor
130830-121WIMDMental Health Counselor

Organizations & group practices 1

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": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1447769039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 W RYAN RD",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531544401",
            "telephone_number": "414-343-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12630 W NORTH AVE BLDG E",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054626",
            "telephone_number": "262-785-1008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "147 W Ryan Rd",
            "address_purpose": "LOCATION",
            "city": "Oak Creek",
            "state": "WI",
            "postal_code": "531544401",
            "country_code": "US",
            "telephone_number": "414-343-6414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHACHTNER",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "18243-130",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "130830-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.