Healthcare Provider Details

I. General information

NPI: 1992614507
Provider Name (Legal Business Name): REGIUS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 HARTBROOK DR STE 201
HARTLAND WI
53029-1444
US

IV. Provider business mailing address

510 HARTBROOK DR STE 201
HARTLAND WI
53029-1444
US

V. Phone/Fax

Practice location:
  • Phone: 262-224-7237
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: AMANDA FOREVER
Title or Position: OWNER
Credential: LCSW
Phone: 262-224-7237