Healthcare Provider Details

I. General information

NPI: 1457273682
Provider Name (Legal Business Name): CHRISTOPHER STERN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 FORDEM AVE
MADISON WI
53704-4696
US

IV. Provider business mailing address

2120 FORDEM AVE
MADISON WI
53704-4696
US

V. Phone/Fax

Practice location:
  • Phone: 608-250-6634
  • Fax: 608-250-6637
Mailing address:
  • Phone: 608-250-6634
  • Fax: 608-250-6637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1234-228
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: