Healthcare Provider Details

I. General information

NPI: 1730058900
Provider Name (Legal Business Name): RACHEL BRIGHTMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S BLOUNT ST
MADISON WI
53703-4664
US

IV. Provider business mailing address

30 S BROOM ST
MADISON WI
53703-3144
US

V. Phone/Fax

Practice location:
  • Phone: 608-405-5111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number135883-121
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: