Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jason Lee Fairweather, LPC, SACIT, CSIT

Individual provider Professional Counselor · NPI 1689278590

Jason Lee Fairweather, LPC, SACIT, CSIT is a Mental Health Counselor in Berlin, Wisconsin. Qualified in 2020, 6 years ago. Practices with County of Green Lake, a 5-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
6
Licensed in
WI
In the registry since
2020
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

See every abbreviation used in this directory →

Practice location Address checks out

553 Broadway
Berlin, WI 54923-1323
Phone: (920) 204-6590
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 10532-125 (WI)

Record details

NPI number1689278590
Entity typeIndividual (Type 1)
GenderMale
Credentials LPC , SACIT , CSIT
Sole proprietorYes
NPI enumeratedNovember 23, 2020
Last updated in NPPESSeptember 26, 2023
Certification dateSeptember 26, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice County Of Green Lake — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount