Heather Marie Bruckschen, LPC, CSAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

11268-125 Issued in WI

Practice address

339 Reed Ave
Manitowoc, WI 54220-2020

Phone

(920) 208-6773

NPI assigned

Oct 2, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Heather M Antoniewicz Former name

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Froedtert Manitowoc Medical Group, LLCGroup PAC ID 2365836954, 156 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Froedtert Manitowoc Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Manitowoc, WI
  • NPI 1437829975
  Medicare reassignment Care Compare group NPD
• Core Treatment Services, Inc.

  • Community/Behavioral Health Agency
  • Manitowoc, WI
  • NPI 1659912319

  Professional

  Medicare reassignment NPD
• Core Treatment Services, Inc.

  • Professional Counselor
  • Manitowoc, WI
  • NPI 1982491882
  NPD

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

{
    "created_epoch": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1831609098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 REED AVE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542202020",
            "telephone_number": "920-208-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 REED AVE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542202020",
            "telephone_number": "920-208-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKSCHEN",
        "first_name": "HEATHER",
        "middle_name": "MARIE",
        "credential": "LPC, CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17149-132",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "11268-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100074973",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "ANTONIEWICZ",
            "middle_name": "M",
            "credential": "LPC-IT, SAC-IT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hailey Elizabeth Boyer, SLP
• Carrie L. Brazzale, D.C.
• Elisabeth Breaker, LAT, ATC, PES
• Blake Bredeson, DC
• Emilie Brienen, M.S. CCC-SLP
• Brittany Nicole Bryan
• Abbey Bubolz, RD
• Victoria Bubolz
• Katie Marie Buchholz, O.D.
• Donna Buechner, NPC

• Mental Health Counselor in Manitowoc, WI
• Providers in Manitowoc, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; 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.

Verify at the official NPI Registry.