MEDICARE: THERAPEUTIC INSIGHT

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1447027669
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPEUTIC INSIGHT

Provider Business Mailing Address
First Line	:	7071 S 13TH ST
Second Line	:
City	:	OAK CREEK
State	:	WI
Zip	:	53154-1466
Country	:	US
Telephone Number	:	414-530-4395
Fax Number	:

Provider Business Practice Location Address
First Line	:	7071 S 13TH ST
Second Line	:
City	:	OAK CREEK
State	:	WI
Zip	:	53154-1466
Country	:	US
Telephone Number	:	414-530-4395
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. KRISTIN M ROGUSZSKA
Credential	:	LPC
Telephone Number	:	414-530-4395

Provider Enumeration Date	:	12/07/2023
Last Update Date	:	12/07/2023

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