Active NPI
Jacqueline K Brenizer, SAC
- Addiction (Substance Use Disorder) Counselor
- Siren, WI
National Provider Identifier
1689838765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 15434-131
- Practice address
- 24670 State Road 35 70
Suite 1200
Siren, WI 54872-4418 - Phone
- (715) 349-7233
- Fax
- (715) 349-7205
- NPI assigned
- Jul 17, 2008
- Last updated
- Jul 17, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 15434-131 | WI | Primary |
Addresses
Primary practice location
24670 State Road 35 70
Suite 1200
Siren, WI 54872-4418
Mailing address
24670 State Road 35 70
Suite 1200
Siren, WI 54872-4418
Phone (715) 349-7233
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15434-131 | WI | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216252800000",
"number": "1689838765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24670 STATE ROAD 35 70",
"address_2": "SUITE 1200",
"city": "SIREN",
"state": "WI",
"postal_code": "548724418",
"telephone_number": "715-349-7233",
"fax_number": "715-349-7205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24670 STATE ROAD 35 70",
"address_2": "SUITE 1200",
"city": "SIREN",
"state": "WI",
"postal_code": "548724418",
"telephone_number": "715-349-7233",
"fax_number": "715-349-7205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENIZER",
"first_name": "JACQUELINE",
"middle_name": "K",
"credential": "SAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-17",
"last_updated": "2008-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "15434-131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Siren, WI
- Aurora Community Counseling Employee Support and Services, Inc. (ACCESS, Inc.)
- Aurora Community Counseling Employee Support and Services, Inc.
- Aurora Communtiy Counseling Employee Support & Services, Inc. Dba: Acc
- Kristin L Barnes, MSOT, OTR/L
- Jennifer Anne Bird
- Burnett County Family Resource Center, Inc.
- Jennifer L Chivers, SLP
- Ardyss Carol Collins, C.O.T.A
- County of Burnett
- County of Burnett
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.