Provider Demographics
NPI:1285481333
Name:INTERCONNECTIONS FAMILY THERAPY
Entity type:Organization
Organization Name:INTERCONNECTIONS FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:GEORGE-COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:608-286-2393
Mailing Address - Street 1:702 N BLACKHAWK AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3357
Mailing Address - Country:US
Mailing Address - Phone:608-286-2393
Mailing Address - Fax:608-231-2334
Practice Address - Street 1:702 N BLACKHAWK AVE STE 104
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3357
Practice Address - Country:US
Practice Address - Phone:608-286-2393
Practice Address - Fax:608-231-2334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty