Healthcare Provider Details

I. General information

NPI: 1366841892
Provider Name (Legal Business Name): ERIN MOHRBACKER-TELLIER PSY.D., LPC, CSAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN MOHRBACKER

II. Dates (important events)

Enumeration Date: 08/20/2014
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 4TH ST
PRAIRIE DU SAC WI
53578-1136
US

IV. Provider business mailing address

560 4TH ST
PRAIRIE DU SAC WI
53578-1136
US

V. Phone/Fax

Practice location:
  • Phone: 608-643-3663
  • Fax: 608-370-8177
Mailing address:
  • Phone: 608-643-3663
  • Fax: 608-370-8177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number16264-132
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2178-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: