Rae Jean Bergner, CSAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

16202 Issued in WI

Practice address

15954 Rivers Edge Dr
Hayward, WI 54843-7800

Phone

(715) 634-2541

Fax

(715) 394-2682

NPI assigned

Aug 25, 2009

Last updated

May 7, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1770716771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N 34TH ST STE 200",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548804477",
            "telephone_number": "715-395-5380",
            "fax_number": "715-394-2682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15954 RIVERS EDGE DR",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548437800",
            "telephone_number": "715-634-2541",
            "fax_number": "715-394-2682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3600 Tower Ave",
            "address_purpose": "LOCATION",
            "city": "Superior",
            "state": "WI",
            "postal_code": "548805337",
            "country_code": "US",
            "telephone_number": "715-392-1955",
            "fax_number": "715-392-1935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGNER",
        "first_name": "RAE JEAN",
        "credential": "CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-25",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Annette Basty, LICENSED CLINICAL SO
• John William Bauer
• Susan Beth Bauer, CRNA
• Jamie Lea Taylor Bell, PA-C
• Gina Marie Benson, BSN, RN, PHN
• Tamara E Bergum, MFT
• John Berlin, FNP
• Kari Patricia Berube, OTR/L
• Amy Marilyn Billman
• Bio-Medical Applications of Wisconsin, Inc. (Fresenius Medical Care Hayward)

• Addiction (Substance Use Disorder) Counselor in Hayward, WI
• Providers in Hayward, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; 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.