| Expressive Therapies LLC | |
|
245 N Metro Dr Appleton WI 54913-8572 | |
| (920) 903-1009 | |
| (800) 791-3601 |
| Full Name | Expressive Therapies LLC |
|---|---|
| Speciality | Social Worker |
| Location | 245 N Metro Dr, Appleton, Wisconsin |
| Authorized Official Name and Position | Sara Lynn Devine (CEO) |
| Authorized Official Contact | 9209031009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Expressive Therapies LLC 245 N Metro Dr Appleton WI 54913-8572 Ph: (920) 903-1009 | Expressive Therapies LLC 245 N Metro Dr Appleton WI 54913-8572 Ph: (920) 903-1009 |
| NPI Number | 1225439326 |
|---|---|
| Provider Enumeration Date | 09/08/2014 |
| Last Update Date | 03/13/2025 |
| Certification Date | 03/13/2025 |
| Medicare PECOS PAC ID | 3476871468 |
|---|---|
| Medicare Enrollment ID | O20150423002415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225439326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | () | Secondary |
| 1041C0700X | Social Worker - Clinical | () | Primary |
| 221700000X | Art Therapist | () | Secondary |
| 225A00000X | Music Therapist | () | Secondary |
| Provider Name | Sara L Devine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902936487 PECOS PAC ID: 7214150135 Enrollment ID: I20140522000608 |
| Provider Name | Sandra Marie Nett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740932136 PECOS PAC ID: 9234663113 Enrollment ID: I20250625000830 |
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