Brittany Raven, | |
9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 | |
(608) 783-0506 | |
Not Available |
Full Name | Brittany Raven |
---|---|
Gender | Female |
Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 9532 E 16 Frontage Rd, Onalaska, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265022008 | NPI | - | NPPES |
1003150004 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 19106130 (Wisconsin) | Primary |
Entity Name | Emily Program Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1528165065 PECOS PAC ID: 5193623254 Enrollment ID: O20031229000014 |
Mailing Address | Practice Location Address |
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Brittany Raven, 9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 Ph: () - | Brittany Raven, 9532 E 16 Frontage Rd, Onalaska, WI 54650-6739 Ph: (608) 783-0506 |
Sherrie L Walter, LPC, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 571 Braund St, Onalaska, WI 54650 Phone: 608-785-7000 Fax: 608-785-7477 | |
Katlyn Becker, Counselor Medicare: Not Enrolled in Medicare Practice Location: 9532 E 16 Frontage Rd, Onalaska, WI 54650 Phone: 608-783-0506 | |
Signe M Midelfort-hector, LICSW Counselor Medicare: Medicare Enrolled Practice Location: 123 16th Ave S, Onalaska, WI 54650 Phone: 608-775-2287 | |
Kelsey Ann Martin, LCSW, CSAC, ICS Counselor Medicare: Accepting Medicare Assignments Practice Location: 571 Braund St, Onalaska, WI 54650 Phone: 608-785-7000 Fax: 608-785-7477 | |
Allison Kay Gulbronson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 571 Braund St, Onalaska, WI 54650 Phone: 608-785-7000 | |
Sheridan Kaatz, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1062 Oak Forest Dr Ste 120, Onalaska, WI 54650 Phone: 608-790-9481 Fax: 608-790-9480 | |
Jennifer Lynn Sobolewski, CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 9532 E 16 Frontage Rd, Suite 100, Onalaska, WI 54650 Phone: 608-783-0506 |