Provider Demographics
NPI:1104521772
Name:BEMIS PSYCHOTHERAPY AND CONSULTING, LLC
Entity type:Organization
Organization Name:BEMIS PSYCHOTHERAPY AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GAUSE-BEMIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-451-0448
Mailing Address - Street 1:38 WAUNONA WOODS CT
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-1724
Mailing Address - Country:US
Mailing Address - Phone:715-451-0448
Mailing Address - Fax:
Practice Address - Street 1:5900 MONONA DR STE 313
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53716-3561
Practice Address - Country:US
Practice Address - Phone:608-514-1764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty