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General NPI Number Information
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NPI Number | 1437015807
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Entity Type | Organization
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Legal Business Name | CARISMACOLLECTIVELLC
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Dates
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Enumeration Date | 12/30/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 11060 N BUNTROCK AVE UNIT 6
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City | THIENSVILLE
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State | WI
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Zip | 53092-4485
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Country | US
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Telephone | 414-305-6269
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Fax |
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Provider Business Mailing Address
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Address Line | 11060 N BUNTROCK AVE UNIT 6
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City | THIENSVILLE
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State | WI
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Zip | 53092-4485
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Country | US
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Telephone | 414-305-6269
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Fax |
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Authorized Official
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Title or Position | BCBA, MANAGER
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Name | CARISA WENDT
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Credential |
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Telephone | 414-305-6269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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