MEDICARE: DANA RENEE BASCH LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	1617-226	WI

General Provider Information

NPI Number	:	1821334319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA RENEE BASCH LPC

Provider Business Mailing Address
First Line	:	702 N BLACKHAWK AVE STE 212
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53705-3357
Country	:	US
Telephone Number	:	608-345-3861
Fax Number	:

Provider Business Practice Location Address
First Line	:	702 N BLACKHAWK AVE STE 212
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53705-3357
Country	:	US
Telephone Number	:	608-345-3861
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2013
Last Update Date	:	03/05/2026

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Directions to “ DANA RENEE BASCH LPC” Practice Location

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