Individual
NICHOLAS JOSEPH OVERBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
16535 W BLUEMOUND RD, BROOKFIELD, WI 53005-5936
(262) 789-1191
(262) 821-6180
Mailing address
16535 W BLUEMOUND RD, BROOKFIELD, WI 53005-5936
(262) 789-1191
(262) 821-6180
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
6054-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42170300
—
WI
Enumeration date
07/07/2016
Last updated
07/07/2016
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