Individual provider Active NPI

Darci M Fenske, LPC, SAC-IT

  • Professional Counselor
  • Wauwatosa, WI
National Provider Identifier
1588356992
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8369 Issued in WI
Practice address
1155 N Mayfair Road
Wauwatosa, WI 53226-3456
Phone
(414) 955-8900
Fax
(414) 955-6285
NPI assigned
May 24, 2023
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 8369 WI Primary

Addresses

Primary practice location

1155 N Mayfair Road
Wauwatosa, WI 53226-3456

Mailing address

1155 N Mayfair Road
Wauwatosa, WI 53226-3456
Phone (414) 955-8900

Other identifiers 1

IdentifierTypeStateIssuer
1588356992MedicaidWI

Other names 1

  • Ms. Darci Mae Sagorac Former name

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
I20240318000459 WI Practitioner - Mental Health Counselor 1557708245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Medical College of Wisconsin IncGroup PAC ID 2668384371, 2,092 clinicians

Practice addresses (Care Compare)

1155 N Mayfair Rd
FL 2
Milwaukee, WI 53226-3462
Phone (414) 955-4263

8701 W Watertown Plank
Milwaukee, WI 53226-3548
Phone (414) 805-3666

8701 Watertown Plank Rd
Room 4041 MFRC
Milwaukee, WI 53226-3548
Phone (414) 805-3666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8369WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Medical College of Wisconsin, Inc. CurrentSince Feb 1, 2024 Accepting new patients

Locations

10000 W Innovation Dr
Ste 300
Wauwatosa, WI 53226

1155 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 955-5990

8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1588356992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 N MAYFAIR ROAD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263456",
            "telephone_number": "414-955-8900",
            "fax_number": "414-955-6285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 N MAYFAIR ROAD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263456",
            "telephone_number": "414-955-8900",
            "fax_number": "414-955-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENSKE",
        "first_name": "DARCI",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LPC, SAC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588356992",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DARCI",
            "last_name": "SAGORAC",
            "middle_name": "MAE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.