ALEXANDER GRUBER MARSHALL LPC-IT, SAC-IT
NPI 1750955316
Counselor - Professional in West Bend, WI

Q: What is Alexander Marshall's NPI number?

The NPI number for Alexander Marshall is 1750955316. It was assigned to this individual provider in the NPPES registry on May 18, 2021.

Q: What is Alexander Marshall's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Active since May 18, 2021PECOS Enrolled

400 W RIVER DR, WEST BEND, WI 53090(252) 334-4340(262) 334-4341 Get Directions Write a Review

NPPES record last updated: October 29, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Alexander Gruber Marshall Lpc-it, Sac-it NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALEXANDER GRUBER MARSHALL LPC-IT, SAC-IT (NPI 1750955316) is an individual professional provider in West Bend, Wisconsin, licensed in Wisconsin (5095-226) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS, maintains a secondary practice location in Mayville, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1750955316

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameALEXANDER GRUBER MARSHALLCredential: LPC-IT, SAC-IT

Location Address400 W RIVER DRWest Bend, WI 53090-1518

Mailing Address400 W River DrWest Bend, WI 53090-1518 · (252) 334-4340 · Fax (262) 334-4341

Phone(252) 334-4340

Fax(262) 334-4341

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateMay 18, 2021

Last NPPES UpdateOctober 29, 2021

NPPES CertifiedOctober 29, 2021

✔ NPI 1750955316 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in WI · 5095-226

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 19460-130 (WI)

400 W RIVER DR, West Bend, WI 53090

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Secondary Practice Location 1

Location 11446 Horicon StMayville, WI 53050-1467 · Phone (262) 334-3430 ext. 1 · Fax (920) 644-2251

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Group Health Cooperative-SCW and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alexander Gruber Marshall Lpc-it, Sac-it is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1355878687

PECOS Enrollment IDI20241226001605

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Alexander Marshall reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kettle Moraine Counseling LLC

Same address

Mental Health (Including Community Mental Health Center)

400 W RIVER DR
West Bend, WI 53090

Reassigned Medicare billing, Wisconsin enrollment
32 clinicians in this Medicare group

NPI 1568790954 (262) 334-4340

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. MICAL GUSTAVE SCHAFFER LCSW

Social Worker (Clinical)