Provider Demographics
NPI:1689758005
Name:STREICHER-BREMER, JODI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JODI
Middle Name:
Last Name:STREICHER-BREMER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2063
Mailing Address - Country:US
Mailing Address - Phone:608-255-9330
Mailing Address - Fax:608-255-7810
Practice Address - Street 1:1619 MONROE ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2063
Practice Address - Country:US
Practice Address - Phone:608-255-9330
Practice Address - Fax:608-255-7810
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2642-057103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39153800Medicaid
WI002884027OtherMEDICARE
WI39153800Medicaid