Organization
GREENBUSH PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA MARIE BROOKS (PSYCHOLOGIST/OWNER)
(608) 963-1380
Entity
Organization
Contact information
Practice address
541 S RANDALL AVE, MADISON, WI 53715-1653
(608) 963-1380
Mailing address
6580 MONONA DR # 1153, MONONA, WI 53716-4032
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
10/31/2023
Last updated
10/31/2023
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