Keri Lynn Fatzinger, LCSW, CSAC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Lancaster, WI
NPI 1972979227 · NPPES record last updated Jan 8, 2019
Key facts
- NPI
- 1972979227
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 16226-132 (WI)
- Practice address
- 200 W Alona LN
Lancaster, WI 53813-2202 - Phone
- (608) 723-6357
- Fax
- (608) 723-4417
- NPI assigned
- Aug 20, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- County of Grant
Practice addresses (Care Compare)
200 W Alona LN
Lancaster, WI 53813-2202
Phone (608) 723-6357
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190301001592 | WI | Practitioner - Clinical Social Worker | 3779822184 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Grant | Current |
Accepting new patients | |
| County of Grant Dba Unified Community Services | Current |
Accepting new patients | |
| Quality Addiction Management Inc | Past | Accepting new patients | |
| County of Grant Dba Unified Community Services | Past | Accepting new patients | |
| Quality Addiction Management Inc | Addiction (Substance Use Disorder) | Past | Accepting new patients |
Locations
1122 Professional Dr
Dodgeville, WI 53533
Phone (608) 935-2776
200 W Alona Ln
Lancaster, WI 53813
Phone (608) 723-6357
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8736-123 | WI | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 16226-132 | WI | Yes |
Addresses
Primary practice location
200 W Alona LN
Lancaster, WI 53813-2202
Mailing address
200 W Alona LN
Lancaster, WI 53813-2202
Phone (608) 723-6357
Other practice location 1
151 E Badger Rd Ste A
Madison, WI 53713-2708
Phone (608) 250-2512
Other providers in Lancaster, WI
- Empowerment Counseling, LLC
- Jennifer Engelhart
- Family Care Chiropractic
- Wade L Farmer
- Karen Diane Farris
- Morgan Jewell Faulkner
- Madisen Faull
- Michael L Fernette
- Emily Friederick
- Theran Gage
All providers in Lancaster, WI · Addiction (Substance Use Disorder) Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.