Provider Demographics
NPI:1285057315
Name:SOMMERFIELD, CHRISTOPHER
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:SOMMERFIELD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 8TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-1720
Mailing Address - Country:US
Mailing Address - Phone:608-477-1484
Mailing Address - Fax:608-856-1260
Practice Address - Street 1:908 8TH ST STE 2
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-1720
Practice Address - Country:US
Practice Address - Phone:608-477-1484
Practice Address - Fax:608-856-1260
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-24
Last Update Date:2021-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1038-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty