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NPI Code Detail

MEDICARE: MS. BROOKE CORLYNNE BRISCOE MFT

MEDICARE: MS. BROOKE CORLYNNE BRISCOE MFT
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
1106H00000XMarriage & Family Therapist835-124WI

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 : 1538392584
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BROOKE CORLYNNE BRISCOE MFT
Provider Business Mailing Address
First Line : 1716 FORDEM AVE
Second Line :
City : MADISON
State : WI
Zip : 53704-4604
Country : US
Telephone Number : 608-221-3511
Fax Number : 608-221-3514
Provider Business Practice Location Address
First Line : 1716 FORDEM AVE
Second Line :
City : MADISON
State : WI
Zip : 53704-4604
Country : US
Telephone Number : 608-221-3511
Fax Number : 608-221-3514
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2009
Last Update Date : 08/07/2023

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1437250123 — MRS. JENNIFER RUTH ZEHR MSW, LCSW
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1528232386 — CHILDREN'S SERVICE SOCIETY OF WISCONSIN
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1831356443 — JENNIFER L LARSON CONTI LCSW
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