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NPI Code Detail

MEDICARE: BRAM CHRISTIAN FALEDAS MS-LPC

MEDICARE: BRAM CHRISTIAN FALEDAS MS-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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1154969673
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRAM CHRISTIAN FALEDAS MS-LPC
Provider Business Mailing Address
First Line : 804 CASS ST APT 302
Second Line :
City : LA CROSSE
State : WI
Zip : 54601-4678
Country : US
Telephone Number : 715-889-9067
Fax Number :
Provider Business Practice Location Address
First Line : 124 GRAYSIDE AVE
Second Line :
City : MAUSTON
State : WI
Zip : 53948-1913
Country : US
Telephone Number : 608-847-7575
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2019
Last Update Date : 12/16/2019

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