Gloria Jean Bannasch, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4281-125 Issued in WI

Practice address

2323 W Everett St
Appleton, WI 54914-4749

Phone

(920) 217-7861

Fax

(920) 560-6618

NPI assigned

Mar 6, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Gloria Jean Bannasch 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, 1981

Medicare assignment

May accept Medicare assignment

Group practices

GJB Health Services, LLC 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• GJB Health Services, LLC

  • Psychologist
  • Appleton, WI
  • NPI 1659711687

  WI

  Medicare reassignment Care Compare group Authorized official
• GJB Eeg Services, SC

  • EEG Specialist/Technologist
  • Appleton, WI
  • NPI 1396315321
  NPD Authorized official

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

{
    "created_epoch": "1267833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1477876308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 W EVERETT ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549144749",
            "telephone_number": "920-217-7861",
            "fax_number": "920-560-6618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 W EVERETT ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549144749",
            "telephone_number": "920-217-7861",
            "fax_number": "920-560-6618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNASCH",
        "first_name": "GLORIA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-06",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4281-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00613383",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLORIA",
            "last_name": "BANNASCH",
            "middle_name": "JEAN",
            "prefix": "MRS.",
            "credential": "M.ED.,LPC, NCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert Blakeslee Ballard, MD
• Natalie Anne Banda
• Sheila May Banda, COTA
• Sankalpa Bandi
• Animesh Banerjea
• Avi Bar-Lev, M.D.
• John Barajas, LPC, SAC-IT
• Rebecca Barbosa, OTR
• Richard T Bares, LPC
• James R Bargenquast, MD

• All providers in Appleton, WI
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.