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NPI Code Detail

MEDICARE: SAMANTHA PIERCE

MEDICARE:   SAMANTHA  PIERCE
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 Counselor2949-226WI

General Provider Information

NPI Number : 1164973160
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA PIERCE
Provider Business Mailing Address
First Line : 3900 W BROWN DEER RD
Second Line : SUITE 200
City : BROWN DEER
State : WI
Zip : 53209-1220
Country : US
Telephone Number : 414-540-2170
Fax Number : 414-540-2171
Provider Business Practice Location Address
First Line : 2001 W BELTLINE HWY STE 105
Second Line :
City : MADISON
State : WI
Zip : 53713-2366
Country : US
Telephone Number : 608-405-5125
Fax Number : 86-405-5125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2016
Last Update Date : 04/27/2021

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Directions to “ SAMANTHA PIERCE ” Practice Location

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