Healthcare Provider Details

I. General information

NPI: 1912552878
Provider Name (Legal Business Name): HEART CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2019
Last Update Date: 08/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4706 COTTAGE GROVE RD STE 300
MADISON WI
53716-1354
US

IV. Provider business mailing address

4706 COTTAGE GROVE RD STE 300
MADISON WI
53716-1354
US

V. Phone/Fax

Practice location:
  • Phone: 608-513-2139
  • Fax: 608-541-8258
Mailing address:
  • Phone: 608-513-2139
  • Fax: 608-541-8258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: ELLEN M MERKER
Title or Position: EXECUTIVE DIRECTOR
Credential: LPC-IT
Phone: 608-513-2139