person
Brian L Boomgarden, MSCADC
Mental Health Counselor in Manitowoc, Wisconsin
NPI 1871510677

Brian L Boomgarden is a Mental Health Counselor based in Manitowoc, WI and is specialized in Mental Health. Brian L Boomgarden practices in Manitowoc, WI and has the professional credentials of MSCADC. The NPI Number for Brian L Boomgarden is 1871510677 and holds a License No. 11165 (Wisconsin).

The current practice location address for Brian L Boomgarden is 339 Reed Ave, Manitowoc, WI and can be reached out via phone at 920-320-8600 and via fax at 920-320-8662. You can also correspond with Brian L Boomgarden through the mailing address at PO BOX 2290, MANITOWOC, WI - 54221-2290 (mailing address contact number: 920-320-8600).

Location: 339 Reed Ave, Manitowoc, WI, 54221-2290
person
Provider Profile Details
NPI Number
1871510677
Provider Name
Brian L Boomgarden
Credential
MSCADC
Provider Entity Type
Individual
Gender
Male
Address
339 Reed Ave, Manitowoc, WI, 54221-2290
Phone Number
920-320-8600
Fax Number
920-320-8662
Provider Enumeration Date
07/16/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
13647 01 NETWORK HEALTH PLAN
39647200 05 WI
390806395 01 CIGNA
institution
Provider Business Practice Location Address Details
Address
339 Reed Ave
City
State
Zip
54220-2020
Phone Number
920-320-8600
Fax Number
920-320-8662
person
Provider Business Mailing Address Details
Address
339 Reed Ave
City
State
Zip
54220-2020
Phone Number
920-320-8600
Fax Number
920-320-8662
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
2898-123 (Wisconsin)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
11165 (Wisconsin)
Definition
Definition to come...
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