Healthcare Provider Details

I. General information

NPI: 1437221470
Provider Name (Legal Business Name): BEHREND COUNSELING AND PSYCHOLOGICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 12/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S BEDFORD ST SUITE 4
MADISON WI
53703-3691
US

IV. Provider business mailing address

850 SCHUSTER ROAD
SUN PRAIRIE WI
53590-2437
US

V. Phone/Fax

Practice location:
  • Phone: 608-834-6400
  • Fax:
Mailing address:
  • Phone: 608-834-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1113057
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number1113057
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number1113057
License Number StateWI

VIII. Authorized Official

Name: DR. JEANNE MARIE BEHREND
Title or Position: PSYCHOLOGIST OWNER
Credential: PH.D.
Phone: 608-834-6400