Beautifully Broken Counseling LLC
Organization Active NPI Mental Health Counselor · De Pere, WI
NPI 1336889062 · NPPES record last updated Mar 30, 2022
Key facts
- NPI
- 1336889062
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Legal business name
- BEAUTIFULLY BROKEN COUNSELING LLC
- Practice address
- 1216 Maplewood CT
De Pere, WI 54115-4232 - Phone
- (920) 334-0607
- NPI assigned
- Mar 30, 2022
- Organization subpart
- No
Authorized official
- Name
- Amanda Radtke, LPC
- Title
- Owner
- Phone
- (920) 334-0607
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | Yes |
Addresses
Primary practice location
1216 Maplewood CT
De Pere, WI 54115-4232
Mailing address
1216 Maplewood CT
De Pere, WI 54115-4232
Other providers in De Pere, WI
- Amber Marie Bassindale
- Hannah Leigh Bauer
- Emily Baumler
- Edward D Bayer
- Bayside Chiropractic LLC
- Christopher George Bechakas
- Bellin Memorial Hospital Inc
- Bellin Memorial Hospital Inc
- Bellin Memorial Hospital Inc
- Bellin Psychiatric Center Inc
All providers in De Pere, WI · Mental Health 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 Mar 30, 2022. 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.