Healthcare Provider Details

I. General information

NPI: 1417418427
Provider Name (Legal Business Name): MELISSA CHRISTINE BADERTSCHER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2019
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 W NATIONAL AVE
MILWAUKEE WI
53204-1347
US

IV. Provider business mailing address

N11W27482 WILDWOOD LN
WAUKESHA WI
53188-1212
US

V. Phone/Fax

Practice location:
  • Phone: 414-380-5477
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8636-125
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8636-125
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number8636-125
License Number StateWI
# 4
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBACB1075392
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number24-264
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: