Courtney Berens

Individual provider Active NPI Professional Counselor · Maynard, MA

NPI 1043676745 · NPPES record last updated Nov 14, 2023

Key facts

NPI
1043676745
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
7978-125 (WI)
Practice address
141 Parker St Ste 306
Maynard, MA 01754-2180
Phone
(267) 937-3340
NPI assigned
Jan 11, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
7978-125WIMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Professional Counselor 101YP2500X 7978-125 WI Yes

Addresses

Primary practice location

141 Parker St Ste 306
Maynard, MA 01754-2180

Mailing address

141 Parker St Ste 306
Maynard, MA 01754-2180
Phone (267) 937-3340

Other practice location 1

3900 W Brown Deer Rd Ste 200
Brown Deer, WI 53209-1220
Phone (414) 540-2170

Other practice location 2

514 Riverview Ave
Waukesha, WI 53188-3631
Phone (262) 548-7719

Other providers in Maynard, MA

All providers in Maynard, MA · Professional Counselor in Massachusetts

Sources for this page

Verify at the official NPI Registry.