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General NPI Number Information
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NPI Number | 1083274534
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Entity Type | Individual
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Provider Name | BREANA J SEUFFER MA, LPC-IT, SAC-IT
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Gender | Female
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Dates
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Enumeration Date | 06/17/2019
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | W2333 COMMERCIAL ST
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City | POY SIPPI
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State | WI
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Zip | 54967-8108
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Country | US
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Telephone | 920-379-0009
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 386
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City | POY SIPPI
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State | WI
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Zip | 54967-0386
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Country | US
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Telephone | 920-379-0009
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8115-125
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | WI
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