MEDICARE: MELISSA CHRISTINE BADERTSCHER 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
1	101YM0800X	Mental Health Counselor	8636-125	WI
2	101YP2500X	Professional Counselor	8636-125	WI
3	101Y00000X	Counselor	8636-125	WI
4	103K00000X	Behavior Analyst	BACB1075392	WI
5	221700000X	Art Therapist	24-264	WI

General Provider Information

NPI Number	:	1417418427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA CHRISTINE BADERTSCHER LPC

Provider Business Mailing Address
First Line	:	N11W27482 WILDWOOD LN
Second Line	:
City	:	WAUKESHA
State	:	WI
Zip	:	53188-1212
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1021 W NATIONAL AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53204-1347
Country	:	US
Telephone Number	:	414-380-5477
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2019
Last Update Date	:	10/22/2025

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