Healthcare Provider Details

I. General information

NPI: 1932927118
Provider Name (Legal Business Name): BRIANA ROBERTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2024
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

384 W SUMNER ST
HARTFORD WI
53027-1421
US

IV. Provider business mailing address

13035 W BLUEMOUND RD STE 100
BROOKFIELD WI
53005-8001
US

V. Phone/Fax

Practice location:
  • Phone: 262-223-6125
  • Fax:
Mailing address:
  • Phone: 262-223-6125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number12239-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: