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Organization

BE THE CHANGE HEALTH AND WELLNESS, LLC

Active
Other names
Be the Change Health and Wellness
Organization subpart
No

Provider details

NPI number
Authorized official
JOELLE KATHLEEN OTTOSON LCSW (CLINICAL SUPERVISOR)
(262) 719-7609
Entity
Organization

Contact information

Practice address
240 N MILWAUKEE ST # 202, MILWAUKEE, WI 53202-5830
(262) 646-8288
Mailing address
240 N MILWAUKEE ST # 202, MILWAUKEE, WI 53202-5830
(262) 646-8288

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1013302611
NPI
01
1013343870
NPI
01
1134147952
NPI
01
1194273888
NPI
01
1487818086
NPI
01
1679591416
NPI
Enumeration date
04/19/2020
Last updated
11/09/2023
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