Individual
BENNO W KOLLMANSBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LPC
Contact information
Practice address
903 MINERAL POINT AVE, JANESVILLE, WI 53548-2970
(608) 756-5555
(608) 756-0174
Mailing address
903 MINERAL POINT AVE, JANESVILLE, WI 53548-2970
(608) 756-5555
(608) 756-0174
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
833-125
WI
1041C0700X
Clinical Social Worker
Primary
2065
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39196500
—
WI
01
—
KOLLMBEN MO
MERCYCARE INSURANCE
WI
Enumeration date
01/22/2007
Last updated
06/26/2012
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