Individual provider Active NPI

Larissa Fravel

  • Professional Counselor
  • Appleton, WI
National Provider Identifier
1841641586
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5984-125 Issued in WI
Practice address
1620 S Lawe St Ste 1
Appleton, WI 54915-2419
Phone
(920) 915-0102
Fax
(920) 481-3121
NPI assigned
Jun 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 5984-125 WI
Professional Counselor 101YP2500X 5984-125 WI Primary

Addresses

Primary practice location

1620 S Lawe St Ste 1
Appleton, WI 54915-2419

Mailing address

1620 S Lawe St
Ste 1
Appleton, WI 54915-2419
Phone (920) 284-9676

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240314001347 WI Practitioner - Mental Health Counselor 2860836731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reflection, LLCGroup PAC ID 0042654915, 5 clinicians

Practice addresses (Care Compare)

1620 S Lawe St
Suite 1
Appleton, WI 54915-2419
Phone (920) 284-9676

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Reflection, LLC Mental Health CurrentSince Mar 6, 2018 Accepting new patients
Molinski Counseling & Consulting Services Professional PastSince Dec 17, 2023 Accepting new patients

Locations

1620 S Lawe St
Ste 5
Appleton, WI 54915
Phone (920) 955-9355

1620 S Lawe St
Ste 1
Appleton, WI 54915
Phone (920) 284-9676

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1841641586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 S LAWE ST",
            "address_2": "STE 1",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549152419",
            "telephone_number": "920-284-9676",
            "fax_number": "920-481-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 S LAWE ST STE 1",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549152419",
            "telephone_number": "920-915-0102",
            "fax_number": "920-481-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAVEL",
        "first_name": "LARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "5984-125",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "5984-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.