Provider Demographics
NPI:1356885404
Name:BELCOURT, SKYLER W (MS)
Entity type:Individual
Prefix:
First Name:SKYLER
Middle Name:W
Last Name:BELCOURT
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:WESLEY
Other - Middle Name:SKYLER
Other - Last Name:BELCOURT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 KESSEL CT STE 105
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-6227
Mailing Address - Country:US
Mailing Address - Phone:608-280-2700
Mailing Address - Fax:
Practice Address - Street 1:2275 DEMING WAY STE 180
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-5527
Practice Address - Country:US
Practice Address - Phone:608-282-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health