Individual provider Active NPI

Bryan Robert Jonet, LPC

  • Professional Counselor
  • Green Bay, WI
National Provider Identifier
1710135413
Registry record updated Sep 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3705-125 Issued in WI
Practice address
2339 Cedar RDG
Sutie 4
Green Bay, WI 54313-5700
Phone
(920) 497-6161
Fax
(920) 498-0476
NPI assigned
Sep 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3705-125 WI Primary

Addresses

Primary practice location

2339 Cedar RDG
Sutie 4
Green Bay, WI 54313-5700

Mailing address

2339 Cedar RDG
Sutie 4
Green Bay, WI 54313-5700
Phone (920) 497-6161

Other identifiers 1

IdentifierTypeStateIssuer
43737900MedicaidWI

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
3705-125WIMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220572800000",
    "number": "1710135413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2339 CEDAR RDG",
            "address_2": "SUTIE 4",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543135700",
            "telephone_number": "920-497-6161",
            "fax_number": "920-498-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2339 CEDAR RDG",
            "address_2": "SUTIE 4",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543135700",
            "telephone_number": "920-497-6161",
            "fax_number": "920-498-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONET",
        "first_name": "BRYAN",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-05",
        "last_updated": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "3705-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43737900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.

Verify at the official NPI Registry.