| Expressive Therapies Llc | |
|
510 E Wisconsin Ave A Appleton WI 54911-4865 | |
| (920) 284-0891 | |
| (800) 791-3601 |
| Full Name | Expressive Therapies Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 510 E Wisconsin Ave, Appleton, Wisconsin |
| Authorized Official Name and Position | Sara Lynn Devine (OWNER, PRIMARY THERAPIST) |
| Authorized Official Contact | 9202840891 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Expressive Therapies Llc 510 E Wisconsin Ave A Appleton WI 54911-4865 Ph: (920) 284-0891 | Expressive Therapies Llc 510 E Wisconsin Ave A Appleton WI 54911-4865 Ph: (920) 284-0891 |
| NPI Number | 1225439326 |
|---|---|
| Provider Enumeration Date | 09/08/2014 |
| Last Update Date | 09/08/2014 |
| Medicare PECOS PAC ID | 3476871468 |
|---|---|
| Medicare Enrollment ID | O20150423002415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225439326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 7854-123 (Wisconsin) | Primary |
| Provider Name | Sara L Devine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902936487 PECOS PAC ID: 7214150135 Enrollment ID: I20140522000608 |
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