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General NPI Number Information
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NPI Number | 1366054579
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Entity Type | Individual
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Provider Name | SHEM M BIEBERT MS, LPC
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Gender | Male
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Dates
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Enumeration Date | 08/19/2020
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Last Update Date | 08/30/2022
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Provider Practice Location Address
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Address Line | 2520 N WAUWATOSA AVE
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City | WAUWATOSA
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State | WI
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Zip | 53213-1135
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Country | US
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Telephone | 800-438-1772
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Fax | 262-345-5562
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Provider Business Mailing Address
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Address Line | W175N11120 STONEWOOD DR
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City | GERMANTOWN
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State | WI
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Zip | 53022-4799
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Country | US
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Telephone | 800-438-1772
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Fax | 262-345-5562
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 19254-130
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4759-226
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8712-125
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License Number State | WI
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