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NPI Code Detail

MEDICARE: BRETT MICHAEL MASBRUCH CSAC

MEDICARE: BRETT MICHAEL MASBRUCH CSAC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor14161WI

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 : 1396887857
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRETT MICHAEL MASBRUCH CSAC
Provider Business Mailing Address
First Line : 3113 E WASHINGTON AVE
Second Line :
City : MADISON
State : WI
Zip : 53704-4330
Country : US
Telephone Number : 608-242-0220
Fax Number : 608-242-1166
Provider Business Practice Location Address
First Line : 3113 E WASHINGTON AVE
Second Line :
City : MADISON
State : WI
Zip : 53704-4330
Country : US
Telephone Number : 608-242-0220
Fax Number : 608-242-1166
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 07/08/2007

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Directions to “ BRETT MICHAEL MASBRUCH CSAC” Practice Location

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