MR. JASEN ALAN EBERHARDT (NPI# 1376021782) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376021782 |
| Entity Type | Individual |
| Full Name | MR. JASEN ALAN EBERHARDT |
| Credential | SAC-IT |
| Practice Address |
223 Wisconsin Ave Ste B Waukesha WI 53186-4968 |
| Practice Telephone | 2627017257 |
| Mailing Telephone | 2627017257 |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
18552-130 | WI | Behavioral Health & Social Service Providers |
| Street Address |
223 WISCONSIN AVE STE B |
| City | WAUKESHA |
| State | WI |
| Zip Code | 53186-4968 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295391472 | Christine Lowdon Triggs | Dentist | 21680 West Bluemound Rd, Waukesha, WI 53186 | 2019-05-14 |
| 1881182889 | Allure Medical of Wisconsin Pllc | Clinic/Center | 1930 W Bluemound Rd Ste 340, Waukesha, WI 53186 | 2018-04-25 |
| 1316462104 | Mary B Mckee | Dietitian, Registered | 22370 W Bluemound Rd, #102, Waukesha, WI 53186 | 2017-08-14 |
| 1740738343 | Rebecca Menelle | Physical Therapist | 1809 Shepherd Ct, Apt 206, Waukesha, WI 53186 | 2016-09-13 |
| 1568919876 | Dianne Isnard | Physical Therapist | W231n1440 Corporate Court, Waukesha, WI 53186 | 2016-09-02 |
| 1982065991 | Brandon James Decker | Nurse Practitioner | 21775 Hillcrest Drive, Waukesha, WI 53186 | 2016-03-18 |
| 1598142937 | Sophia Marie Klingbiel | Social Worker | 1515 Paramount Dr., Waukesha, WI 53186 | 2015-05-06 |
| 1326478165 | Glen D Haberman | Dentist | 141 Wisconsin Avenue, Waukesha, WI 53186 | 2013-11-14 |
| 1487991014 | Sara Nicole Francis | Counselor | 217 Wisconsin Ave Ste 211, Waukesha, WI 53186 | 2013-01-16 |
| 1770862054 | Alex Colque, M.d. S.c. | Plastic Surgery | 21675 E Moreland Blvd, Suite 100, Waukesha, WI 53186 | 2011-08-04 |
| Find all providers in zip 53186 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467917609 | Choice 2 Change Therapy, Inc. | Counselor | 217 Wisconsin Ave Ste 114, Waukesha, WI 53186-4946 | 2019-02-01 |
| 1851864029 | Daniel Chadwick | Counselor | 741 N Grand Ave Ste 204, Waukesha, WI 53186-4841 | 2019-01-09 |
| 1952601833 | Heidi J Rubio | Counselor | 210 Nw Barstow St, Suite 110, Waukesha, WI 53188 | 2010-10-26 |
| 1477793180 | Sarah M Smith | Counselor | W231n1440 Corporate Ct # 310, Waukesha, WI 53186-1303 | 2009-02-21 |
| 1952577488 | Patricia Rose Gutierrez | Counselor | 147 Randall St, Waukesha, WI 53188-3528 | 2008-05-05 |
| 1902091135 | Tamara L Erickson | Counselor | 2314 Grandview Blvd, Suites 301 & 110, Waukesha, WI 53188-1675 | 2007-09-11 |
| 1275734105 | Denise Louise Drum | Counselor | 407 Pilot Ct Ste 400, Waukesha, WI 53188-2466 | 2007-05-29 |
| 1124182126 | David Poehlmann | Counselor | 2422 N Grandview Blvd, Suite 501, Waukesha, WI 53188-6105 | 2006-12-21 |
| 1629132840 | Maribeth Rose Dettlaff | Counselor | 500 Riverview Ave Ste 2, Waukesha, WI 53188-3632 | 2006-12-21 |
| 1013078518 | Daniel E Hermsen | Counselor | W231 N1440 Corporate Court, Suite 310, Waukesha, WI 53186-1301 | 2006-12-12 |
| Find all providers in WAUKESHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.