IndividualActive
Brody Fanshaw, MS, LPC
NPI 1689390981 · Mental Health Counselor · Sun Prairie, WI
Provider details
- NPI number
- 1689390981
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Credential
- MS, LPC
- Sex
- Male
- Sole proprietor
- Yes
- License
- 7151-226 (WI)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
121 S Bristol St Ste 102
Sun Prairie, WI 53590-2995
Phone: (608) 285-2911
Approximate (ZIP-level) locationGet directions
Mailing address
6408 Bridge Rd Apt 245
Monona, WI 53713-1832
Registry dates
- Enumerated
- 2022-10-18
- Last updated
- 2024-08-14
- Certified
- 2024-08-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.