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NPI Code Detail

MEDICARE: DANIELLE RENEE BIRDEAU LPC

MEDICARE: DANIELLE RENEE BIRDEAU LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor3265125WI
2101YM0800XMental Health Counselor3265125WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124045570
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE RENEE BIRDEAU LPC
Provider Business Mailing Address
First Line : 514 RIVERVIEW AVE
Second Line :
City : WAUKESHA
State : WI
Zip : 53188-3631
Country : US
Telephone Number : 262-548-7666
Fax Number : 262-970-6696
Provider Business Practice Location Address
First Line : 514 RIVERVIEW AVE
Second Line :
City : WAUKESHA
State : WI
Zip : 53188-3631
Country : US
Telephone Number : 262-548-7666
Fax Number : 262-970-6696
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2006
Last Update Date : 05/27/2022

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