Mr Brody Thomas Fanshaw, MS, LPC in Sun Prairie, WI

Mr Brody Thomas Fanshaw, MS, LPC is a medicare enrolled "Counselor - Mental Health" provider in Sun Prairie, Wisconsin. His current practice location is 121 S Bristol St Ste 102, Sun Prairie, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (608) 285-2911.

Mr Brody Thomas Fanshaw is licensed to practice in Wisconsin (license number 7151-226) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1689390981.

Contact Information

	Mr Brody Thomas Fanshaw, MS, LPC
	121 S Bristol St Ste 102, Sun Prairie, WI 53590-2995
	(608) 285-2911
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Brody Thomas Fanshaw
Gender	Male
Speciality	Counselor - Mental Health
Location	121 S Bristol St Ste 102, Sun Prairie, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1689390981
Provider Enumeration Date: 10/18/2022
Last Update Date: 08/14/2024

Medicare PECOS Information:

PECOS PAC ID: 3779023163
Enrollment ID: I20240912000653

Medical Identifiers

Medical identifiers for Mr Brody Thomas Fanshaw such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1689390981	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	7151-226 (Wisconsin)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Brody Thomas Fanshaw allows following entities to bill medicare on his behalf.

Entity Name	Insight Counseling & Wellness Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1447673702 PECOS PAC ID: 6608264742 Enrollment ID: O20211022001432

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Brody Thomas Fanshaw is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Brody Thomas Fanshaw, MS, LPC 6408 Bridge Rd Apt 245, Monona, WI 53713-1832 Ph: (608) 285-2911	Mr Brody Thomas Fanshaw, MS, LPC 121 S Bristol St Ste 102, Sun Prairie, WI 53590-2995 Ph: (608) 285-2911

Reviews and Comments

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Mr Brody Thomas Fanshaw, MS, LPC - Medicare Counselor in Sun Prairie, WI