Ertl, Brenda Jane
Ertl, Brenda Jane is an individual health care provider with primary practice located at 420 3Rd St S , Wisconsin Rapids WI 54494-4350. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Ertl, Brenda Jane can be contacted via phone (715) 712-1370.Contact Information
Primary practice address
420 3Rd St S
Wisconsin Rapids WI 54494-4350
Phone: (715) 712-1370
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 101356-125 | Wisconsin |
Profile Details
| NPI number | 1598386583 |
|---|---|
| LBN Legal business name | Ertl, Brenda Jane |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 30th, 2020 |
| Last updated | Aug 27th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598386583 | NPPES |
| Wisconsin | MEDICAID | 100101179 |
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