Fanchen Gao, LPCIT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4887-226 Issued in WI

Practice address

1971 Washington St Ste 200
Grafton, WI 53024-2125

Phone

(262) 377-6276

Fax

(262) 377-6289

NPI assigned

Apr 5, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alarus Healthcare, LLC

  • Multi-Specialty Clinic/Center
  • Grafton, WI
  • NPI 1457788242
  NPD
• Alarus Home Health LLC

  • In Home Supportive Care Agency
  • Grafton, WI
  • NPI 1164834974
  NPD (past)

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1649859943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4848 N LYDELL AVE APT 125",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532175851",
            "telephone_number": "414-399-2788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1971 WASHINGTON ST STE 200",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530242125",
            "telephone_number": "262-377-6276",
            "fax_number": "262-377-6289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1622 Chestnut St",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "530953014",
            "country_code": "US",
            "telephone_number": "262-306-9800",
            "fax_number": "262-306-9802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAO",
        "first_name": "FANCHEN",
        "credential": "LPCIT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "19275-130",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "4887-226",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4887-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Frueh, FNP
• Eric S. Gaenslen, M.D.
• Sarah Lyne Godbert Gaethke, M.D.
• Jasmine Gaines
• Brian E Gajafsky, PT CSCS
• Taylor L Gatlin
• Jill C Georgen, PA-C
• Maria Georgen
• Kenneth Jacob Gerhardt Jr., PHARMD
• Karen Marie Geschke, PT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.