NPIMap

Organization Active NPI

Aspen Family Counseling

  • Mental Health Counselor
  • Portage, WI
National Provider Identifier
1689632309
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1066 Issued in 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
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Barry D Erath, LCSWNPI 1861436065
Title
Clinic Director
Phone
(608) 742-5020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 1066 WI Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040202000469 WI Part B Supplier - Clinic/Group Practice 0840193157 Receives reassigned benefits from 5 practitioners
Practice locations: Portage, WI

National Provider Directory

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

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1689632309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2639 NEW PINERY RD",
            "address_2": "SUITE 1",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539011110",
            "telephone_number": "608-742-5020",
            "fax_number": "608-742-3641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 NEW PINERY RD",
            "address_2": "SUITE 1",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539011110",
            "telephone_number": "608-742-5020",
            "fax_number": "608-742-3641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPEN FAMILY COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ERATH",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "608-742-5020",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "1066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.