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NPI Code Detail

MEDICARE: THERAPIZED LLC

MEDICARE: THERAPIZED LLC
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 Worker

General Provider Information

NPI Number : 1942070891
Entity Type Code : Organization
Provider Name (Legal Business Name) : THERAPIZED LLC
Provider Business Mailing Address
First Line : 5215 N IRONWOOD RD STE 202
Second Line :
City : GLENDALE
State : WI
Zip : 53217-4908
Country : US
Telephone Number : 715-903-6444
Fax Number :
Provider Business Practice Location Address
First Line : 5215 N IRONWOOD RD STE 202
Second Line :
City : GLENDALE
State : WI
Zip : 53217-4908
Country : US
Telephone Number : 715-903-6444
Fax Number :
Authorized Official
Title or Position : LCSW
Name : JEREMIAH JOHNSON
Credential : LCSW
Telephone Number : 715-903-6444
Provider Enumeration Date : 01/02/2024
Last Update Date : 01/02/2024

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Directions to “THERAPIZED LLC ” Practice Location

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