| Mrs Shannon M Brice, LCSW | |
|
250 S Washington St, Saint Croix Falls, WI 54024-4405 | |
| (715) 246-4840 | |
| (715) 254-9459 |
| Full Name | Mrs Shannon M Brice |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 250 S Washington St, Saint Croix Falls, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871716787 | NPI | - | NPPES |
| 372794 | Other | WI | MHN HMC INSURANCE |
| 40938900 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 7379-123 (Wisconsin) | Primary |
| Entity Name | Family Therapy Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215239736 PECOS PAC ID: 5395273536 Enrollment ID: O20250115002328 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Shannon M Brice, LCSW 250 S Washington St, Saint Croix Falls, WI 54024-4405 Ph: (715) 246-4840 | Mrs Shannon M Brice, LCSW 250 S Washington St, Saint Croix Falls, WI 54024-4405 Ph: (715) 246-4840 |
Mrs. Amy Joy Hering, MSW, CAPSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 250 S Washington St, Saint Croix Falls, WI 54024 Phone: 715-246-4849 | |
Ethan Halainen, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 250 S Washington St, Saint Croix Falls, WI 54024 Phone: 715-246-4840 | |
Mr. Bradley Alan Foss, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 112 N Madison St, Saint Croix Falls, WI 54024 Phone: 715-483-3800 Fax: 715-483-9801 |