Active NPI
Sean Patrick Fauls, MS, LPC
- Professional Counselor
- Elkhorn, WI
National Provider Identifier
1750490264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3030-125
- Practice address
- W4051 County Road NN
Elkhorn, WI 53121-4338 - Phone
- (262) 741-3200
- Fax
- (262) 741-3217
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3030-125 | WI | Primary |
Addresses
Primary practice location
W4051 County Road NN
Elkhorn, WI 53121-4338
Mailing address
W4051 County Road NN
Elkhorn, WI 53121-4338
Phone (262) 741-3200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43585100 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231222002366 | WI | Practitioner - Mental Health Counselor | 7214387869 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- University of Virginia School of Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Affiliated Clinical Services Inc
Practice addresses (Care Compare)
111 E Washington St
West Bend, WI 53095-2571
Phone (262) 338-2717
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affiliated Clinical Services Inc | Current | Accepting new patients |
Locations
111 E Washington St
West Bend, WI 53095
Phone (262) 338-2717
Organizations & group practices 1
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": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1750490264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W4051 COUNTY ROAD NN",
"city": "ELKHORN",
"state": "WI",
"postal_code": "531214338",
"telephone_number": "262-741-3200",
"fax_number": "262-741-3217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W4051 COUNTY ROAD NN",
"city": "ELKHORN",
"state": "WI",
"postal_code": "531214338",
"telephone_number": "262-741-3200",
"fax_number": "262-741-3217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAULS",
"first_name": "SEAN",
"middle_name": "PATRICK",
"name_prefix": "Mr.",
"credential": "MS, LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "3030-125",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "43585100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elkhorn, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.