| Be The Change Health And Wellness | |
|
240 N Milwaukee St # 202 Milwaukee WI 53202-5830 | |
| (262) 646-8288 | |
| Not Available |
| Full Name | Be The Change Health And Wellness |
|---|---|
| Speciality | Social Worker |
| Location | 240 N Milwaukee St # 202, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Joelle Kathleen Ottoson (CLINICAL SUPERVISOR) |
| Authorized Official Contact | 2627197609 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Be The Change Health And Wellness 240 N Milwaukee St # 202 Milwaukee WI 53202-5830 Ph: (262) 646-8288 | Be The Change Health And Wellness 240 N Milwaukee St # 202 Milwaukee WI 53202-5830 Ph: (262) 646-8288 |
| NPI Number | 1659991727 |
|---|---|
| Provider Enumeration Date | 04/19/2020 |
| Last Update Date | 11/09/2023 |
| Certification Date | 11/09/2023 |
| Medicare PECOS PAC ID | 8022429471 |
|---|---|
| Medicare Enrollment ID | O20201116002833 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659991727 | NPI | - | NPPES |
| 1013302611 | Other | NPI | |
| 1487818086 | Other | NPI | |
| 1679591416 | Other | NPI | |
| 1013343870 | Other | NPI | |
| 1134147952 | Other | NPI | |
| 1194273888 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Joelle K Ottoson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679591416 PECOS PAC ID: 0749241883 Enrollment ID: I20041022000280 |
| Provider Name | Alexandra Marie Debaker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194273888 PECOS PAC ID: 2769812668 Enrollment ID: I20200416002223 |
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