Robin A Deethardt, LPC
Individual provider Active NPI Professional Counselor · Portage, WI
NPI 1124259841 · NPPES record last updated Jul 29, 2009
Key facts
- NPI
- 1124259841
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- Practice address
- 2901 Hunters TRL
Portage, WI 53901-3403 - Phone
- (608) 742-5518
- Fax
- (608) 742-4087
- NPI assigned
- Jul 29, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Yes |
Addresses
Primary practice location
2901 Hunters TRL
Portage, WI 53901-3403
Mailing address
2901 Hunters TRL
Portage, WI 53901-3403
Phone (608) 742-5518
Other providers in Portage, WI
- Dean Health Systems, Inc.
- Dean Retail Services, Inc.
- Danielle Debruyne
- Nichole Decorah
- Timothy A Mical Deering
- Kelsey Deets
- Jennelle Marie Denoyer
- Derek J Cripps LLC
- Emily E Desjarlais
- Jill Dickson-Baures
All providers in Portage, WI · Professional Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.