Individual provider · Type 1 NPI

Brody Thomas Fanshaw, MS, LPC

Mental Health Counselor · Sun Prairie, WI

NPI number 1689390981 Active

Practice location

121 S Bristol St Ste 102
Sun Prairie, WI 53590-2995

Call (608) 285-2911 Map

Mailing address

6408 Bridge Rd Apt 245
Monona, WI 53713-1832

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X7151-226 (WI)

Mental Health Counselor: Definition to come...

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About NPI 1689390981

Brody Thomas Fanshaw, MS, LPC's National Provider Identifier is 1689390981, issued on Oct 18, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Sun Prairie, WI. The record was last updated on Aug 14, 2024.