Traci L Brown, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4053 Issued in WI

Practice address

W6240 Communication CT Ste 2
Appleton, WI 54914-8549

Phone

(920) 364-0747

NPI assigned

Jun 2, 2009

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

Other identifiers 1

Other names 1

• Traci L Van Remortel 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

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.

• Virago Wellness Initiative, LLC

  • Clinical Psychologist
  • Appleton, WI
  • NPI 1285412411

  Professional

  Medicare reassignment NPD

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1982830121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W6240 COMMUNICATION CT STE 2",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549148549",
            "telephone_number": "920-364-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W6240 COMMUNICATION CT STE 2",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549148549",
            "telephone_number": "920-364-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TRACI",
        "middle_name": "L",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-02",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40930300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "VAN REMORTEL",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Deanna Jeanne Brown, LCSW
• Emilie Marie-Voigt Brown
• Jennifer Brown, DO
• Leah Brown, MT-BC
• Olivia Brown, BCBA
• Abigail P Brownell, DO
• Robert G Brucker, M.D.
• Renee R Bruckner
• Teagan Brunk, PA-C
• Larae Jean Bruno, RN

• Professional Counselor in Appleton, WI
• Providers in Appleton, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.