Provider Demographics
NPI:1801818950
Name:WOMEN & FAMILIES' PSYCHOTHERAPY RESOURCES, INC
Entity Type:Organization
Organization Name:WOMEN & FAMILIES' PSYCHOTHERAPY RESOURCES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:P
Authorized Official - Last Name:BEYER
Authorized Official - Suffix:
Authorized Official - Credentials:AAB
Authorized Official - Phone:262-542-0123
Mailing Address - Street 1:707 W. MORELAND BLVD.
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188
Mailing Address - Country:US
Mailing Address - Phone:262-542-0123
Mailing Address - Fax:262-542-1199
Practice Address - Street 1:707 W. MORELAND BLVD.
Practice Address - Street 2:SUITE 5
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188
Practice Address - Country:US
Practice Address - Phone:262-542-0123
Practice Address - Fax:262-542-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1368-123101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42141200Medicaid