Vandebrown, Travis H

Vandebrown, Travis H is an sole proprietor health care provider with primary practice located at 333 E Washington St Ste 2100 , West Bend WI 53095-2503. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Vandebrown, Travis H can be contacted via phone (262) 335-4583.

Contact Information

Primary practice address
333 E Washington St Ste 2100 West Bend WI 53095-2503
Phone: (262) 335-4583
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 132330-121 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 16017-132 Wisconsin
Behavioral Health & Social Service Providers / Clinical 1041C0700X 11401-123 Wisconsin

Profile Details

NPI number 1245601772
LBN Legal business name Vandebrown, Travis H
Credentials MSW, LCSW, CSAC, ICS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 9th, 2015
Last updated Sep 26th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245601772 NPPES
Wisconsin MEDICAID 100050428

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