William Jay Blevins, LMFT
Individual provider Active NPI Marriage & Family Therapist · Middleton, WI
NPI 1154957314 · NPPES record last updated Apr 6, 2024
Key facts
- NPI
- 1154957314
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 908-124 (WI)
- Practice address
- 2564 Branch St Ste B5
Middleton, WI 53562-2850 - Phone
- (608) 492-0069
- NPI assigned
- Mar 19, 2020
- Sex
- Male
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 908-124 | WI | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 908-124 | WI | Yes |
Addresses
Primary practice location
2564 Branch St Ste B5
Middleton, WI 53562-2850
Mailing address
210 Junction Rd Apt 209
Madison, WI 53717-2673
Phone (608) 444-7105
Other providers in Middleton, WI
- Zeki Beyhan
- Bala Bhagavath
- Laurie A Bigelow
- Amanda M Bird
- Erika Blain
- David D Bogenrief
- Thomas S Bolan
- Cynthia P Bonk
- Penina Boros
- Sarah Bowman
All providers in Middleton, WI · Marriage & Family Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2024. 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.