ALEXIS VAN EPEREN (MA, NBCC, LPC, ICS) – Mental Health Counselor, NPI 1104378470

ALEXIS VAN EPEREN (MA, NBCC, LPC, ICS) is a healthcare provider. based in Neenah, Wisconsin. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA, NBCC, LPC, ICS. The NPI Number for ALEXIS VAN EPEREN (MA, NBCC, LPC, ICS) is 1104378470

Main info

Female
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
ALEXIS VAN EPEREN (MA, NBCC, LPC, ICS)
NPI
1104378470
Phone
(920) 573-6089
Address
1609 LONE OAK DR
Enumeration Date
2 November 2016
Last Update Date
8 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9202346842
Graduation Year
2016 (10 years ago)
PAC ID
9931601093
Group Practice PAC ID
0840724522
Professional Enrollment ID
I20250908001169
Address ID
WI549139407AP1835XDRXX414
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness85
Years active:9State licenses:0Digital endpointsOther names

1,748 MENTAL HEALTH COUNSELOR in WI

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Provider Addresses for ALEXIS VAN EPEREN (MA, NBCC, LPC, ICS)

  • 1609, Lone Oak Drive, Neenah, Winnebago County, Wisconsin, 54956, United States

    NEENAH, WI 549566537

    Phone: (920) 573-6089

    Type: Mailing

  • 1173, South Washburn Street, Oshkosh, Winnebago County, Wisconsin, 54904, United States

    SUITE H

    OSHKOSH, WI 549048041

    Phone: (920) 383-1090

    Type: Location

  • 1835 E EDGEWOOD DR STE 105107

    APPLETON, WI 549139407

    Phone: (920) 234-6842

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-09-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250908001169IMental Health CounselorWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 54956)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0840724522View full group profile
NameSpecialtyState
Clinical Social WorkerPA
Mental Health CounselorWI
Mental Health CounselorWI
Clinical Social WorkerWI
Mental Health CounselorWI
Mental Health CounselorWI
Mental Health CounselorWI
Mental Health CounselorWI

Reviews

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Frequently asked questions

What number should I use to identify ALEXIS VAN EPEREN (MA, NBCC, LPC, ICS) for billing?
Administrative and clinical systems typically use NPI 1104378470 for ALEXIS VAN EPEREN (MA, NBCC, LPC, ICS).
Is ALEXIS VAN EPEREN (MA, NBCC, LPC, ICS) currently accepting referrals based on NPI status?
Registry metadata lists ALEXIS VAN EPEREN (MA, NBCC, LPC, ICS) as active.
What services align with ALEXIS VAN EPEREN (MA, NBCC, LPC, ICS)'s listing?
ALEXIS VAN EPEREN (MA, NBCC, LPC, ICS)'s public classification highlights Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Which community is linked to ALEXIS VAN EPEREN (MA, NBCC, LPC, ICS)?
ALEXIS VAN EPEREN (MA, NBCC, LPC, ICS) shows a connection to Neenah, Wisconsin in registry-derived data.
Who maintains ALEXIS VAN EPEREN (MA, NBCC, LPC, ICS)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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