Joy Evon Clikeman, LMFT

Individual provider Active NPI Marriage & Family Therapist · Elkhorn, WI

NPI 1154511269 · NPPES record last updated Jul 26, 2007

Key facts

NPI
1154511269
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
619-124 (WI)
Practice address
1 1/2 W Geneva St
Elkhorn, WI 53121-1722
Phone
(262) 723-3424
NPI assigned
Jul 26, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
619-124WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Credence Therapy Associates Inc Past
since Aug 1, 2002
Accepting new patients
American Behavioral Clinics, SC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 619-124 WI Yes

Addresses

Primary practice location

1 1/2 W Geneva St
Elkhorn, WI 53121-1722

Mailing address

1 1/2 W Geneva St
Elkhorn, WI 53121-1722
Phone (262) 723-3424

Other providers in Elkhorn, WI

All providers in Elkhorn, WI · Marriage & Family Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.