Individual provider Active NPI

Douglas Bisbee

  • Mental Health Counselor
  • Menasha, WI
National Provider Identifier
1659651073
Registry record updated Aug 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1151-226 Issued in WI
Practice address
1478 Kenwood Ctr
Suite 1
Menasha, WI 54952-1161
Phone
(920) 886-9319
NPI assigned
Aug 17, 2011
Last updated
Aug 17, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1151-226 WI Primary

Addresses

Primary practice location

1478 Kenwood Ctr
Suite 1
Menasha, WI 54952-1161

Mailing address

1592 Worth Ave
Neenah, WI 54956-5041

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
I20240112003088 WI Practitioner - Mental Health Counselor 2668823733 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samaritan Counseling Center of the Fox Valley, Inc.Group PAC ID 9234034349, 11 clinicians

Practice addresses (Care Compare)

110 Church Ave
Oshkosh, WI 54901-4746
Phone 9208869319118

1205 Province Ter
Menasha, WI 54952-7017
Phone 9208869319118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1151-226WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Counseling Center of the Fox Valley, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

1478 Kenwood Dr
Ste 1
Menasha, WI 54952
Phone (920) 886-9319

110 Church Ave
Oshkosh, WI 54901
Phone (920) 235-1678

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": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313539200000",
    "number": "1659651073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1592 WORTH AVE",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549565041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1478 KENWOOD CTR",
            "address_2": "SUITE 1",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521161",
            "telephone_number": "920-886-9319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISBEE",
        "first_name": "DOUGLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-17",
        "last_updated": "2011-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "1151-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menasha, WI

Sources for this page

Verify at the official NPI Registry.