Healthcare Provider Details

I. General information

NPI: 1356885404
Provider Name (Legal Business Name): SKYLER W BELCOURT M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: WESLEY SKYLER BELCOURT

II. Dates (important events)

Enumeration Date: 12/08/2016
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2275 DEMING WAY STE 180
MIDDLETON WI
53562-5527
US

IV. Provider business mailing address

25 KESSEL CT STE 105
MADISON WI
53711-6227
US

V. Phone/Fax

Practice location:
  • Phone: 608-282-8200
  • Fax:
Mailing address:
  • Phone: 608-280-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: