Healthcare Provider Details

I. General information

NPI: 1871857516
Provider Name (Legal Business Name): GINA MARIE BRINDOWSKI LPC, SAC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GINA MASULLI

II. Dates (important events)

Enumeration Date: 06/27/2012
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N91W17194 APPLETON AVE STE 204
MENOMONEE FALLS WI
53051-2083
US

IV. Provider business mailing address

N91W17194 APPLETON AVE STE 204
MENOMONEE FALLS WI
53051-2083
US

V. Phone/Fax

Practice location:
  • Phone: 414-502-7780
  • Fax:
Mailing address:
  • Phone: 414-502-7780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number15849
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5583
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: