Jason Lee Fairweather, LPC, SACIT, CSIT is a medicare enrolled "Counselor - Professional" provider in Berlin, Wisconsin. He graduated from healthcare school in 2020 and has 6 years of diverse experience with area of expertise as Mental Health Counselor. He is a member of the group practice County Of Green Lake and his current practice location is
553 Broadway, Berlin, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(920) 204-6590.
Jason Lee Fairweather is licensed to practice in Wisconsin (license number 10532-125) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1689278590.
Healthcare Provider's Profile
| Full Name | Jason Lee Fairweather |
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| Gender | Male |
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| Speciality | Mental Health Counselor |
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| Experience | 6 Years |
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| Location | 553 Broadway, Berlin, Wisconsin |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Jason Lee Fairweather graduated from medical school in 2020
NPI Data:
- NPI Number: 1689278590
- Provider Enumeration Date: 11/23/2020
- Last Update Date: 09/26/2023
Medicare PECOS Information:
- PECOS PAC ID: 2466804075
- Enrollment ID: I20240119000724
Medical Identifiers
Medical identifiers for Jason Lee Fairweather such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1689278590 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YP2500X | Counselor - Professional | 10532-125 (Wisconsin) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| County Of Green Lake | 6507881265 | 5 |
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. Jason Lee Fairweather allows following entities to bill medicare on his behalf.
| Entity Name | County Of Green Lake |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1780867408
PECOS PAC ID: 6507881265
Enrollment ID: O20051011001149 |
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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. Jason Lee Fairweather 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 |
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Jason Lee Fairweather, LPC, SACIT, CSIT
553 Broadway,
Berlin, WI 54923-1323
Ph: (920) 204-6590 | Jason Lee Fairweather, LPC, SACIT, CSIT
553 Broadway,
Berlin, WI 54923-1323
Ph: (920) 204-6590 |
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