Individual provider Active NPI

Timothy Bain

  • Mental Health Counselor
  • Brookfield, WI
National Provider Identifier
1649751074
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
13035 W Bluemound Rd Ste 100
Brookfield, WI 53005-8001
Phone
(262) 784-1121
NPI assigned
Aug 23, 2018
Last updated
Aug 23, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

13035 W Bluemound Rd Ste 100
Brookfield, WI 53005-8001

Mailing address

13035 W Bluemound Rd Ste 100
Brookfield, WI 53005-8001

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
I20260218002143 WI Practitioner - Mental Health Counselor 4587144407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

34700 Valley Rd
Oconomowoc, WI 53066-4599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rogers Memorial Hospital Incorporated CurrentSince Jan 21, 2026 Accepting new patients
Rogers Memorial Hospital Incorporated Past Accepting new patients

Locations

34700 Valley Rd
Oconomowoc, WI 53066

11101 W Lincoln Ave
West Allis, WI 53227
Phone (414) 203-4500

2424 S 102nd St
West Allis, WI 53227
Phone (414) 373-7474

Organizations & group practices 2

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": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1649751074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13035 W BLUEMOUND RD STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530058001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13035 W BLUEMOUND RD STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530058001",
            "telephone_number": "262-784-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIN",
        "first_name": "TIMOTHY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.