Provider Demographics
NPI:1336355460
Name:NEUPERT, JOHN CORNELIUS (MS, CSAC, LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CORNELIUS
Last Name:NEUPERT
Suffix:
Gender:M
Credentials:MS, CSAC, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 NORTHLAND DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-1342
Mailing Address - Country:US
Mailing Address - Phone:608-249-7281
Mailing Address - Fax:
Practice Address - Street 1:5 ODANA CT
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1120
Practice Address - Country:US
Practice Address - Phone:608-277-0610
Practice Address - Fax:608-270-6651
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1438-132101YA0400X
WI4080-123101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health