Mind-Body Program

LBN: Lauri Gebhard
Mind-Body Program is an health care organization with primary practice located at 10855 W Potter Rd , Wauwatosa WI 53226-3439. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Health. Behavioral Health & Social Service Providers / Clinical is the primary health care specialty. Lauri Gebhard can be contacted via phone (414) 407-6664, or through Gebhard, Lauri Christine via phone (414) 407-6664.

Contact Information

Primary practice address
10855 W Potter Rd Wauwatosa WI 53226-3439
Phone: (414) 407-6664
Fax: (414) 302-1330
Website:
Map and Directions
Authorized official contact:
Name: Gebhard, Lauri Christine PH.D
Phone: (414) 407-6664

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2028 Wisconsin
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 2028 Wisconsin
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2028 Wisconsin
Behavioral Health & Social Service Providers / Health 103TH0004X 2028 Wisconsin

Profile Details

NPI number 1104012244
LBN Legal business name Lauri Gebhard
DBA Doing business as Mind-Body Program
Authorized official Gebhard, Lauri Christine PH.D
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 22nd, 2007
Last updated Sep 22nd, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104012244 NPPES
Wisconsin MEDICAID 39121000

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