Fawn Ashley Rose Andersen, LPC, SAC-IT
NPI 1376038760ActiveIndividual· Counselor, Professional· Fitchburg, WI
Counselor, Professional (LPC, SAC-IT) in Fitchburg, Wisconsin, licensed in WI, with an NPI issued in June 2018. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1376038760 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LPC, SAC-IT |
| Sole proprietor | No |
| NPI issued | Jun 27, 2018 |
| Last updated in NPPES | Jul 9, 2026 |
| Certified by provider | Jul 9, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Professional Primary | 101YP2500X | 12028-125 | WI |
| Behavior Technician | 106S00000X | RBT-18-58203 | WI |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | 20600-130 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Mental Health Counselor (WI) |
|---|
Education and affiliations
| Graduation year | 2023 |
|---|---|
| Medicare specialty | Mental Health Counselor |
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