Organization · NPI-2

212 Psychotherapy LLC

Counselor, Professional · Madison, WI

NPI number1053941666
StatusActive
Last updated in NPPESMay 9, 2024

Details

NPI
1053941666
Entity type
Organization (NPI-2)
Legal business name
212 Psychotherapy LLC
Organization subpart
No
Enumeration date
Jan 22, 2020
Certification date
May 9, 2024
Last updated
May 9, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, Professional––Yes

Practice location

7109 Brindley Cir
Madison, WI 53719-2128

Phone 608-205-8650

Mailing address

7109 Brindley Cir
Madison, WI 53719-2128

Phone 608-516-4347

Authorized official

Tanya Kc Hiser
Owner
6085164347

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