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NPI Code Detail

MEDICARE: BETHANY T BOJCIC LCSW

MEDICARE: BETHANY T BOJCIC LCSW
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
11041C0700XClinical Social Worker8400-123WI

General Provider Information

NPI Number : 1457890493
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETHANY T BOJCIC LCSW
Provider Business Mailing Address
First Line : 9000 W WISCONSIN AVE
Second Line : MS 958
City : MILWAUKEE
State : WI
Zip : 53226-4874
Country : US
Telephone Number : 414-266-7615
Fax Number : 414-266-6238
Provider Business Practice Location Address
First Line : 4855 S MOORLAND RD STE 150
Second Line :
City : NEW BERLIN
State : WI
Zip : 53151-7495
Country : US
Telephone Number : 414-292-4242
Fax Number : 414-425-9803
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2017
Last Update Date : 08/12/2022

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Directions to “ BETHANY T BOJCIC LCSW” Practice Location

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