| Kb Psychotherapy & Emdr | |
|
647 W Main St Lake Geneva WI 53147-1990 | |
| (262) 806-1467 | |
| Not Available |
| Full Name | Kb Psychotherapy & Emdr |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 647 W Main St, Lake Geneva, Wisconsin |
| Authorized Official Name and Position | Kate M Bullard (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 8478099218 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kb Psychotherapy & Emdr 5120 Red Pine Ave Gurnee IL 60031-1776 Ph: (262) 806-1467 | Kb Psychotherapy & Emdr 647 W Main St Lake Geneva WI 53147-1990 Ph: (262) 806-1467 |
| NPI Number | 1063993038 |
|---|---|
| Provider Enumeration Date | 08/27/2018 |
| Last Update Date | 10/17/2024 |
| Certification Date | 10/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063993038 | NPI | - | NPPES |
| 1033550934 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 16105-131 (Wisconsin) | Primary |
| 101YP2500X | Counselor - Professional | 6363-125 (Wisconsin) | Secondary |
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