Aspen Family Counseling
Organization Active NPI Mental Health Counselor · Portage, WI
NPI 1689632309 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1689632309
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 1066 (WI)
- Legal business name
- ASPEN FAMILY COUNSELING
- Practice address
- 2639 New Pinery Rd
Suite 1
Portage, WI 53901-1110 - Phone
- (608) 742-5020
- Fax
- (608) 742-3641
- NPI assigned
- May 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Barry D Erath, LCSW
- Title
- Clinic Director
- Phone
- (608) 742-5020
Practitioners 15
-
Barry D. Erath, LCSW
-
Lori N Greer, PSYD
-
James M Swan Jr., APNP
-
Heather Jane Gove, LPC
-
Rachel L Harry, MS, LPC
-
Sarah J Kravick, LMFT
-
Jill Colleen Nowlen, MSW, LCSW.
-
Sara B Shaver, LMFT
-
Corinne C Stoner, LPC
-
Brian A Vasey, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040202000469 | WI | Part B Supplier - Clinic/Group Practice | 0840193157 |
Receives reassigned benefits from 5 practitioners Practice locations: Portage, WI |
National Provider Directory
Locations
2639 New Pinery Rd
Ste 1
Portage, WI 53901
Phone (608) 742-5020
625 E Slifer St
Ste 2
Portage, WI 53901
Phone (608) 742-5020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | 1066 | WI | Yes |
Addresses
Primary practice location
2639 New Pinery Rd
Suite 1
Portage, WI 53901-1110
Mailing address
2639 New Pinery Rd
Suite 1
Portage, WI 53901-1110
Phone (608) 742-5020
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 570028 | Other | WI | DEAN HEALTHCARE PROVIDER |
| 81145030 | Other | WI | THE ALLIANCE PROVIDER # |
| 42202000 | Medicaid | WI |
Other providers in Portage, WI
- Tracey S Allison
- Casey Jo Ambort
- Katrina M Anderson Schaller
- Dawn Anderson-Mueller
- Roy Anderson
- Laura E Ballweg
- Christi-Jo Barden
- Dennis Michael Barrett-Neira
- Madison Bear
- Beard Chiropractic Family Wellness Clinic, LLC
All providers in Portage, WI · Mental Health Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.