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General NPI Number Information
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NPI Number | 1245951920
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Entity Type | Organization
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Legal Business Name | CUP OF THOUGHTS THERAPY, LLC
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Dates
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Enumeration Date | 09/09/2022
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 310 LANCE DR UNIT 210
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City | TWIN LAKES
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State | WI
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Zip | 53181-9292
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Country | US
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Telephone | 608-400-4320
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Fax |
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Provider Business Mailing Address
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Address Line | 310 LANCE DR. SUITE 210
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City | TWIN LAKES
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State | WI
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Zip | 53181-9292
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Country | US
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Telephone | 608-295-4797
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MELINDA PEDERSEN
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Credential | MS, LPC, NCC
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Telephone | 608-295-4797
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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