Individual provider Active NPI

Sean J. Wasson, LPC, CSAC

  • Professional Counselor
  • Janesville, WI
National Provider Identifier
1689097958
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6825-125 Issued in WI
Practice address
903 Mineral Point Ave
Janesville, WI 53548-2970
Phone
(608) 756-5555
Fax
(608) 756-0174
NPI assigned
Jan 22, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15771-132 WI
Professional Counselor 101YP2500X 6825-125 WI Primary

Addresses

Primary practice location

903 Mineral Point Ave
Janesville, WI 53548-2970

Mailing address

903 Mineral Point Ave
Janesville, WI 53548-2970
Phone (608) 756-5555

Other practice location 1

203 W Sunny Ln
Janesville, WI 53546-9091
Phone (608) 741-4515

Other identifiers 1

IdentifierTypeStateIssuer
1689097958MedicaidWI

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
I20240212003584 WI Practitioner - Mental Health Counselor 9830532316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, 749 clinicians

Practice addresses (Care Compare)

903 Mineral Point Ave
Janesville, WI 53548-2970
Phone (608) 754-3814

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15771-132WIMDAddiction (Substance Use Disorder) Counselor
6825-125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health System Corporation CurrentSince Jan 1, 2024 Accepting new patients
Mercy Health System Corporation CurrentSince Jan 1, 2024 Accepting new patients
Rock Valley Community Programs, Inc. PastSince Aug 19, 2013 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

903 Mineral Point Ave
Janesville, WI 53548
Phone (608) 756-5555

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1390348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1689097958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482970",
            "telephone_number": "608-756-5555",
            "fax_number": "608-756-0174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482970",
            "telephone_number": "608-756-5555",
            "fax_number": "608-756-0174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 W Sunny Ln",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535469091",
            "country_code": "US",
            "telephone_number": "608-741-4515",
            "fax_number": "608-741-4516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASSON",
        "first_name": "SEAN",
        "middle_name": "J.",
        "credential": "LPC, CSAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-22",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15771-132",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6825-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689097958",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

Verify at the official NPI Registry.