Tammy Breault

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6219-125 Issued in WI

Practice address

2367 Beede Lake TRL
Saint Croix Falls, WI 54024-7931

Phone

(715) 553-0159

NPI assigned

Sep 8, 2014

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: 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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 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.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  Professional, WI

  Medicare reassignment Care Compare group NPD
• River Valley Renewal Counseling and Wellness Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Croix Falls, WI
  • NPI 1205436292
  NPD Authorized official

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1902207012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2367 BEEDE LAKE TRL",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540247931",
            "telephone_number": "715-553-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2367 BEEDE LAKE TRL",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540247931",
            "telephone_number": "715-553-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAULT",
        "first_name": "TAMMY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6219-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bont Chiropractic, LLC
• Anita Melodee Bont, MS, MFT
• Steven Scott Bont, DC
• Mark E. Boyken, M.D.
• Breathe and Thrive, LLC
• Shannon M Brice, LCSW
• Megan Brothen, DPT
• Wanda F Brown, N.P.
• Jeanine L Brunclik, M.D.
• Dana Marie Burcar, PA-C

• Professional Counselor in Saint Croix Falls, WI
• Providers in Saint Croix Falls, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.