Gisela P Berger, PH.D.

Individual provider Active NPI Community/Behavioral Health Agency · Mequon, WI

NPI 1457569147 · NPPES record last updated Feb 24, 2012

Key facts

NPI
1457569147
Entity type
Individual (NPI type 1)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
3930 (WI)
Practice address
4313 W Marseilles Dr
Mequon, WI 53092-1173
Phone
(414) 469-5784
NPI assigned
May 18, 2007
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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0701003643VAMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 3930 WI Yes
Professional Counselor 101YP2500X 0701003643 VA

Addresses

Primary practice location

4313 W Marseilles Dr
Mequon, WI 53092-1173

Mailing address

4313 W Marseilles Dr
Mequon, WI 53092-1173
Phone (414) 469-5784

Other providers in Mequon, WI

All providers in Mequon, WI · Community/Behavioral Health Agency in Wisconsin

Sources for this page

Verify at the official NPI Registry.