Rebecca Rae Breitrick, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6889 Issued in WI

Practice address

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

Phone

(262) 785-1008

Fax

(262) 646-6284

NPI assigned

Dec 28, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Rebecca Rae Buettner Former name

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, 2014

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)

Medicare enrollment (NPD)

Enrolled

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.

• Christian Life Counseling LLC

  • Clinical Psychologist
  • Brookfield, WI
  • NPI 1659466860
  Medicare reassignment Care Compare group
• Rawhide Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New London, WI
  • NPI 1841334620
  NPD (past)

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

{
    "created_epoch": "1514419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1477069458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6640 N 110TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532245038",
            "telephone_number": "414-628-6016"
        },
        {
            "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",
            "fax_number": "262-646-6284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6640 N 110th St",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532245038",
            "country_code": "US",
            "telephone_number": "414-628-6016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREITRICK",
        "first_name": "REBECCA",
        "middle_name": "RAE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-28",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "2393",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477069458",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "BUETTNER",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dylan Bray, AA
• James J Bray, PHD
• Jaime Brayer, OTR/L
• Alessandra Brazzoni
• Breathe in Motion, LLC
• Daniel Robert Breitweiser, D.D.S.
• Richard R Brendle
• Shelley Sue Brenholt, PT
• Brew City Auto Rentals
• Mary Sheila Briggs, MSW, APSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.