Provider Demographics
NPI:1376635094
Name:REBECCA D BEAN BEHREND
Entity Type:Organization
Organization Name:REBECCA D BEAN BEHREND
Other - Org Name:BEHREND PSYCHOLOGY CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:FUEHRER
Authorized Official - Suffix:
Authorized Official - Credentials:BSW
Authorized Official - Phone:715-423-2030
Mailing Address - Street 1:464 DALY AVE
Mailing Address - Street 2:#1
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54494-4746
Mailing Address - Country:US
Mailing Address - Phone:175-423-2030
Mailing Address - Fax:715-423-2032
Practice Address - Street 1:464 DALY AVE
Practice Address - Street 2:#1
Practice Address - City:WISCONSIN RAPIDS
Practice Address - State:WI
Practice Address - Zip Code:54494-4746
Practice Address - Country:US
Practice Address - Phone:175-423-2030
Practice Address - Fax:715-423-2032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2352101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32040300Medicaid
WI42242700Medicaid
WI39771800Medicaid
WI43572300Medicaid
WI39131600Medicaid
WIF23374Medicare UPIN
WIP06153Medicare UPIN