| Brandt Badger Llc | |
|
205 N College Ave Ste 613 Bloomington IN 47404-3956 | |
| (812) 200-6122 | |
| (812) 610-1482 |
| Full Name | Brandt Badger Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 205 N College Ave Ste 613, Bloomington, Indiana |
| Authorized Official Name and Position | Jonathan Brandt Badger (MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 8123459919 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brandt Badger Llc 408 E Dodds St Bloomington IN 47401-4819 Ph: (812) 345-9919 | Brandt Badger Llc 205 N College Ave Ste 613 Bloomington IN 47404-3956 Ph: (812) 200-6122 |
| NPI Number | 1386288546 |
|---|---|
| Provider Enumeration Date | 10/31/2019 |
| Last Update Date | 10/31/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386288546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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Diane Menke Pence, Lmhc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 N College Ave, Ste 613, Bloomington, IN 47404 Phone: 812-333-3440 Fax: 812-333-3444 | |
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