Pheynell Branch, AAS, CSAC,CSIT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

15662-132 Issued in WI

Practice address

1650 Wasington Ave
Racine, WI 53403

Phone

(262) 633-5001

NPI assigned

Nov 8, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Associate of Applied Science

State licenses

Practice roles

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.

• Genesis Behavioral Services, Inc.

  • Substance Abuse Rehabilitation Facility
  • West Allis, WI
  • NPI 1568620466
  NPD (past)

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1457780496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6737 W WASHINGTON ST STE 2210",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532145650",
            "telephone_number": "414-777-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 WASINGTON AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "53403",
            "telephone_number": "262-633-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANCH",
        "first_name": "PHEYNELL",
        "name_prefix": "Mrs.",
        "credential": "AAS, CSAC,CSIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15662-132",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15476-133",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paige Borst
• Anna Marie Bort, LPN
• Michael Allen Boticki, PH.D.
• Roger O Boye, MD
• Katherine Braddock
• Wallace Edward Brandies Jr., CSAC ICS
• Michelle Braun, PHD
• Leslie Lee Breidenbach, L.P.N.
• John F. Brennan, MD
• Ashley Brenner

• Addiction (Substance Use Disorder) Counselor in Racine, WI
• Providers in Racine, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; 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.