| Heather Marie Bruckschen, LPC, CSAC | |
|
339 Reed Ave, Manitowoc, WI 54220-2020 | |
| (920) 208-6773 | |
| Not Available |
| Full Name | Heather Marie Bruckschen |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 8 Years |
| Location | 339 Reed Ave, Manitowoc, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831609098 | NPI | - | NPPES |
| 100074973 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 17149-132 (Wisconsin) | Secondary |
| 101YM0800X | Counselor - Mental Health | 11268-125 (Wisconsin) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Froedtert Manitowoc Medical Group, Llc | 2365836954 | 137 |
| Entity Name | Core Treatment Services, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659912319 PECOS PAC ID: 6608267430 Enrollment ID: O20220105000239 |
| Entity Name | Froedtert Manitowoc Medical Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437829975 PECOS PAC ID: 2365836954 Enrollment ID: O20220224001282 |
| Mailing Address | Practice Location Address |
|---|---|
| Heather Marie Bruckschen, LPC, CSAC 339 Reed Ave, Manitowoc, WI 54220-2020 Ph: (920) 208-6773 | Heather Marie Bruckschen, LPC, CSAC 339 Reed Ave, Manitowoc, WI 54220-2020 Ph: (920) 208-6773 |
Lana L. Roever, M.S., S.A.C.I.T. Counselor Medicare: Not Enrolled in Medicare Practice Location: 926 S. 8th Street, Manitowoc, WI 54221 Phone: 920-683-4230 Fax: 920-683-4908 | |
Mrs. Corrin Laurene Applekamp, MS, LPC-IT, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3 Riverview Dr, Manitowoc, WI 54220 Phone: 920-663-1035 | |
Courtney Balthazor, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3 Riverview Dr, Manitowoc, WI 54220 Phone: 920-663-1035 Fax: 920-215-4918 | |
Kirstin Duprey, QTT Counselor Medicare: Not Enrolled in Medicare Practice Location: 926 S 8th St, Manitowoc, WI 54220 Phone: 920-683-4230 | |
Justine Boonperm, Counselor Medicare: Not Enrolled in Medicare Practice Location: 926 S 8th St, Manitowoc, WI 54220 Phone: 920-683-4251 | |
Nicole Bonin, MSW, LCSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 816 Washington St, Manitowoc, WI 54220 Phone: 920-645-3743 | |
Meghan Gehrke, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5005 Vista Rd, Manitowoc, WI 54220 Phone: 920-663-1035 Fax: 920-320-1722 |