Elmbrook Family Counseling Center Llp | |
12690 W North Ave Brookfield WI 53005-4636 | |
(262) 785-9188 | |
Not Available |
Full Name | Elmbrook Family Counseling Center Llp |
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Speciality | Psychologist |
Location | 12690 W North Ave, Brookfield, Wisconsin |
Authorized Official Name and Position | Howard J. Haven (DIRECTOR) |
Authorized Official Contact | 2627859188 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Elmbrook Family Counseling Center Llp 12690 W North Ave Brookfield WI 53005-4636 Ph: (262) 785-9188 | Elmbrook Family Counseling Center Llp 12690 W North Ave Brookfield WI 53005-4636 Ph: (262) 785-9188 |
NPI Number | 1831211309 |
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Provider Enumeration Date | 04/04/2007 |
Last Update Date | 08/29/2007 |
Medicare PECOS PAC ID | 2860396728 |
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Medicare Enrollment ID | O20031121000586 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831211309 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 1297 (Wisconsin) | Primary |
Provider Name | Howard J Haven |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1356401475 PECOS PAC ID: 2668376526 Enrollment ID: I20110216000341 |
Provider Name | Christina M Brigham |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1467796433 PECOS PAC ID: 7113244872 Enrollment ID: I20150318001303 |
Provider Name | Sarah V Hoerl |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1134502743 PECOS PAC ID: 0749544500 Enrollment ID: I20180502000486 |
Provider Name | Leah L O'reilly |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1366823635 PECOS PAC ID: 1153758669 Enrollment ID: I20200224000305 |
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