Brody Thomas Fanshaw, MS, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

7151-226 Issued in WI

Practice address

121 S Bristol St Ste 102
Sun Prairie, WI 53590-2995

Phone

(608) 285-2911

NPI assigned

Oct 18, 2022

Sex

Male

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Insight Counseling & Wellness, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Madison, WI
  • NPI 1447673702
  Medicare reassignment NPD

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1689390981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6408 BRIDGE RD APT 245",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537131832",
            "telephone_number": "608-285-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 S BRISTOL ST STE 102",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535902995",
            "telephone_number": "608-285-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANSHAW",
        "first_name": "BRODY",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-18",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "7151-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Express Sport and Spine S.C.
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• Eye Wisconsin LLC
• F&E Adult Home Care, LLC
• Karina Falcon Gonzalez
• Phyllis Farber, LPN
• Lindsay Felda
• Thomas J Feldman, P.T.
• Dee Felgus, LPC
• Anne Margaret Fischer

• Mental Health Counselor in Sun Prairie, WI
• Providers in Sun Prairie, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.