Tina Pfannerstill, SAC-IT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

18363-130 Issued in WI

Practice address

4550 W Bradley Rd
Brown Deer, WI 53223-3713

Phone

(414) 371-1600

NPI assigned

Nov 16, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• R.E.a.C.H. Inc. Comprehensive Mental Health Clinic

  • Community/Behavioral Health Agency
  • Glendale, WI
  • NPI 1144555152
  NPD (past)

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510790400000",
    "number": "1689188328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8907 N PARK PLAZA CT",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532232164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 W BRADLEY RD",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532233713",
            "telephone_number": "414-371-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFANNERSTILL",
        "first_name": "TINA",
        "name_prefix": "Ms.",
        "credential": "SAC-IT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-16",
        "last_updated": "2017-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "18363-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Palumbo
• Elizabeth L Paly, PT DPT
• Ann Marie Parchment
• Ashlea Pardee
• Yuliy Mukh Pershman, M.D.
• Tiffany Pitts
• Pleasant and Peaceful Home LLC
• Tina L Ploetz, LPC
• Michael D Plotkin, DO
• Kelsey Porada

• Addiction (Substance Use Disorder) Counselor in Brown Deer, WI
• Providers in Brown Deer, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; 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.