Michaella Brickner

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

8409-125 Issued in WI

Practice address

705 S 24TH Ave Ste 400
Wausau, WI 54401-5242

Phone

(715) 848-1457

Fax

(715) 848-2959

NPI assigned

Apr 23, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Children'S Service Society

  • Professional Counselor
  • Wausau, WI
  • NPI 1497884597
  NPD (past)

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1629698378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S 24TH AVE STE 400",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544015242",
            "telephone_number": "715-848-1457",
            "fax_number": "715-848-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICKNER",
        "first_name": "MICHAELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-23",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "4432-226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4432-226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "8409-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629698378",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Brecke, RDH BS MS
• James A Breneman, LPN
• Debra Lynn Breunling, PT
• Aliya Brianne, LPC-IT
• Marie Brick
• Jace Briggs, CPO
• Corey Lee Brimacombe, D.D.S
• Julie A Brinkman, RN
• Sharon Brinkman, CRNA
• Holly K Briquelet Miller

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.