| Badger Counseling Llc | |
|
436 E Longview Dr Ste A Appleton WI 54911-2166 | |
| (920) 239-5017 | |
| Not Available |
| Full Name | Badger Counseling Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 436 E Longview Dr Ste A, Appleton, Wisconsin |
| Authorized Official Name and Position | Breanna L Vonck (OWNER/THERAPIST) |
| Authorized Official Contact | 9202395017 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Badger Counseling Llc 436 E Longview Dr Ste A Appleton WI 54911-2166 Ph: (920) 239-5017 | Badger Counseling Llc 436 E Longview Dr Ste A Appleton WI 54911-2166 Ph: (920) 239-5017 |
| NPI Number | 1083113021 |
|---|---|
| Provider Enumeration Date | 02/05/2018 |
| Last Update Date | 11/07/2022 |
| Certification Date | 11/07/2022 |
| Medicare PECOS PAC ID | 2466714027 |
|---|---|
| Medicare Enrollment ID | O20180319001266 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083113021 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 7786-123 (Wisconsin) | Primary |
| Provider Name | Breanna L Vonck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891077806 PECOS PAC ID: 1153594460 Enrollment ID: I20111102000459 |
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