Tamara E Bergum, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

141-228 Issued in WI

Practice address

15655 W County Road B
Hayward, WI 54843-3251

Phone

(715) 634-0607

Fax

(715) 634-0617

NPI assigned

Feb 5, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265328000000",
    "number": "1972835601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15655 W COUNTY ROAD B",
            "address_2": "P.O. BOX 13251",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548432680",
            "telephone_number": "715-634-0607",
            "fax_number": "715-634-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15655 W COUNTY ROAD B",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548433251",
            "telephone_number": "715-634-0607",
            "fax_number": "715-634-0617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERGUM",
        "first_name": "TAMARA",
        "middle_name": "E",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-05",
        "last_updated": "2010-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "141-228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI DRL",
            "identifier": "141-228",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John William Bauer
• Susan Beth Bauer, CRNA
• Jamie Lea Taylor Bell, PA-C
• Gina Marie Benson, BSN, RN, PHN
• Rae Jean Bergner, CSAC
• John Berlin, FNP
• Kari Patricia Berube, OTR/L
• Amy Marilyn Billman
• Bio-Medical Applications of Wisconsin, Inc.
• Robyn Rene Bjork, MPT,CWS,WCC,CLT-LANA

• Marriage & Family Therapist in Hayward, WI
• Providers in Hayward, WI by specialty
• Marriage & Family Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.