| Be Well Counseling Llc | |
|
420 E Green Bay St Suite 107 Shawano WI 54166-2549 | |
| (715) 853-8953 | |
| (715) 201-0395 |
| Full Name | Be Well Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 420 E Green Bay St, Shawano, Wisconsin |
| Authorized Official Name and Position | Robin C Raber Bergeon (ONWER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 7158538953 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Be Well Counseling Llc N6981 River Dr Shawano WI 54166-4222 Ph: (715) 853-8953 | Be Well Counseling Llc 420 E Green Bay St Suite 107 Shawano WI 54166-2549 Ph: (715) 853-8953 |
| NPI Number | 1083140057 |
|---|---|
| Provider Enumeration Date | 05/11/2017 |
| Last Update Date | 05/11/2017 |
| Medicare PECOS PAC ID | 1557637766 |
|---|---|
| Medicare Enrollment ID | O20171016001502 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083140057 | NPI | - | NPPES |
| 1821136540 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 7539123 (Wisconsin) | Primary |
| Provider Name | Robin C Raber Bergeon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821136540 PECOS PAC ID: 0840566048 Enrollment ID: I20171016001388 |
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