Individual provider Active NPI

Sean Gray

  • Addiction (Substance Use Disorder) Counselor
  • Fitchburg, WI
National Provider Identifier
1699640656
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
20986130 Issued in WI
Practice address
151 E Badger Rd Ste a
Fitchburg, WI 53713-2726
Phone
(608) 250-2512
Fax
(608) 250-2516
NPI assigned
Oct 9, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 20986130 WI Primary

Addresses

Primary practice location

151 E Badger Rd Ste a
Fitchburg, WI 53713-2726

Mailing address

151 E Badger Rd Ste a
Fitchburg, WI 53713-2726
Phone (608) 250-2512

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

LicenseStateTypeSpecialty
20986130WIMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Addiction Management Inc Addiction (Substance Use Disorder) PastSince Oct 12, 2025 Accepting new patients
Quality Addiction Management Inc PastSince Oct 12, 2025 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1759968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1699640656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 E BADGER RD STE A",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537132726",
            "telephone_number": "608-250-2512",
            "fax_number": "608-250-2516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 E BADGER RD STE A",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537132726",
            "telephone_number": "608-250-2512",
            "fax_number": "608-250-2516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "SEAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-09",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "20986130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; 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.