Bryanna Kim Ashenbrener, MA, LPC

Individual provider Active NPI Professional Counselor · Manitowoc, WI

NPI 1689056830 · NPPES record last updated Jan 24, 2017

Key facts

NPI
1689056830
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
6280-125 (WI)
Practice address
980 Maritime Dr Ste 1
Manitowoc, WI 54220-2962
Phone
(920) 905-1020
Fax
(920) 905-1020
NPI assigned
Jun 24, 2015
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6280-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Clarity Counseling LLC Professional Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6280-125 WI Yes

Addresses

Primary practice location

980 Maritime Dr Ste 1
Manitowoc, WI 54220-2962

Mailing address

980 Maritime Dr Ste 1
Manitowoc, WI 54220-2962
Phone (920) 905-1020

Other identifiers

IdentifierTypeStateIssuer
1689056830MedicaidWI

Other names

  • Bryanna Kim Mertens Former name

Other providers in Manitowoc, WI

All providers in Manitowoc, WI · Professional Counselor in Wisconsin

Sources for this page

Verify at the official NPI Registry.