Provider Demographics
NPI:1316211998
Name:BEDI, AMI S (LPC)
Entity Type:Individual
Prefix:MS
First Name:AMI
Middle Name:S
Last Name:BEDI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 W FAIRY CHASM RD
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-1767
Mailing Address - Country:US
Mailing Address - Phone:414-807-8282
Mailing Address - Fax:
Practice Address - Street 1:1110 N OLD WORLD 3RD ST STE 401
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53203-1117
Practice Address - Country:US
Practice Address - Phone:414-807-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4753-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health