Provider Demographics
NPI:1982039830
Name:BEHRENS, DANIELLE K (LPC, SAC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:K
Last Name:BEHRENS
Suffix:
Gender:F
Credentials:LPC, SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1466 WATER ST STE 2
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-2915
Mailing Address - Country:US
Mailing Address - Phone:715-341-6672
Mailing Address - Fax:715-341-8004
Practice Address - Street 1:1466 WATER ST STE 2
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-2915
Practice Address - Country:US
Practice Address - Phone:715-341-6672
Practice Address - Fax:715-341-8004
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6281101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1982039830Medicaid