Provider Demographics
NPI:1437221470
Name:BEHREND COUNSELING AND PSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:BEHREND COUNSELING AND PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BEHREND
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:608-834-6400
Mailing Address - Street 1:850 SCHUSTER ROAD
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-2437
Mailing Address - Country:US
Mailing Address - Phone:608-834-6400
Mailing Address - Fax:
Practice Address - Street 1:301 S BEDFORD ST
Practice Address - Street 2:SUITE 4
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-3691
Practice Address - Country:US
Practice Address - Phone:608-834-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1113057103TB0200X, 103TC1900X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39034400Medicaid
50639OtherNTNL RGSTR OF HLTH SRVC