Provider Demographics
NPI:1144513946
Name:LARSCHEID, BRITTANY N (LCSW, CSAC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:N
Last Name:LARSCHEID
Suffix:
Gender:F
Credentials:LCSW, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E SAINT JOSEPH ST
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-2241
Mailing Address - Country:US
Mailing Address - Phone:920-431-5674
Mailing Address - Fax:920-437-0533
Practice Address - Street 1:301 E SAINT JOSEPH ST
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-2241
Practice Address - Country:US
Practice Address - Phone:920-431-5674
Practice Address - Fax:920-437-0533
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15631-132101YA0400X
WI7998-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIK400219751Medicare Oscar/Certification