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General NPI Number Information
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NPI Number | 1841549565
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Entity Type | Individual
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Provider Name | REGINA MAE WEBER MS
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Gender | Female
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Dates
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Enumeration Date | 09/10/2012
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 175 N CORPORATE DR STE 150
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City | BROOKFIELD
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State | WI
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Zip | 53045-5899
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Country | US
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Telephone | 877-552-6672
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Fax |
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Provider Business Mailing Address
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Address Line | 60 REVERE DR STE 100
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City | NORTHBROOK
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State | IL
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Zip | 60062-1590
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Country | US
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Telephone | 877-552-6672
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH60587896
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License Number State | WA
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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 | 6375-125
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License Number State | WI
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