Marybeth Banach, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5687-125 Issued in WI

Practice address

510 Hartbrook Dr Ste 201
Hartland, WI 53029-1444

Phone

(262) 853-9084

NPI assigned

May 28, 2015

Last updated

May 28, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Service Agency of Waukesha County Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waukesha, WI
  • NPI 1568404671
  Medicare reassignment NPD

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432771200000",
    "number": "1760861413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HARTBROOK DRIVE, SUITE 201",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "53029",
            "telephone_number": "262-853-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 HARTBROOK DR STE 201",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530291444",
            "telephone_number": "262-853-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANACH",
        "first_name": "MARYBETH",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2015-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5687-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Avgoulas, RPH
• Avid at Home LLC
• Bailey Family Dental
• Andrew S Bailey, LCSW
• Terese Honel Bailey, D.D.S.
• Robin Mary Bartling, RN
• Kerin Dianna Baumann
• Melinda Belger, RN
• Curt Bertram, CPO
• Barbara Binder, MSW, LCSW

• Professional Counselor in Hartland, WI
• Providers in Hartland, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.