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General NPI Number Information
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NPI Number | 1417603192
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Entity Type | Individual
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Provider Name | EVA BRONWYN SZOCIK
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Gender | Female
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Dates
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Enumeration Date | 02/22/2022
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 1001 FOURIER DR STE 200
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City | MADISON
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State | WI
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Zip | 53717-1958
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Country | US
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Telephone | 608-740-2001
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Fax | 608-740-2002
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Provider Business Mailing Address
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Address Line | 1900 SILVER LAKE RD NW STE 110
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City | NEW BRIGHTON
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State | MN
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Zip | 55112-1789
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Country | US
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Telephone | 651-628-9566
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Fax | 651-628-0411
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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 | 174400000X
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Taxonomy Name | Specialist
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7893
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License Number State | WI
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