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General NPI Number Information
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NPI Number | 1083140057
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Entity Type | Organization
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Legal Business Name | BE WELL COUNSELING LLC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 204 E CAPITOL DR STE 104
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City | MILWAUKEE
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State | WI
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Zip | 53212-1200
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Country | US
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Telephone | 715-853-8953
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Fax | 414-928-3049
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Provider Business Mailing Address
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Address Line | 7033 N ROCKLEDGE AVE
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City | GLENDALE
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State | WI
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Zip | 53209-2941
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Country | US
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Telephone | 715-853-8953
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Fax | 414-928-3049
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Authorized Official
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Title or Position | ONWER/PSYCHOTHERAPIST
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Name | ROBIN C RABER BERGEON
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Credential | LCSW, CSAC
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Telephone | 715-853-8953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7539123
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License Number State | WI
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