Seals, Bonneka Tiffany

Seals, Bonneka Tiffany is an individual health care provider with primary practice located at 3235 N 124Th St , Brookfield WI 53005. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Seals, Bonneka Tiffany can be contacted via phone (262) 290-3315.

Contact Information

Primary practice address
3235 N 124Th St Brookfield WI 53005
Phone: (262) 290-3315
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 6744-125 Wisconsin
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 6744-125 Wisconsin
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 16190-132 Wisconsin

Profile Details

NPI number 1093163065
LBN Legal business name Seals, Bonneka Tiffany
Credentials MS, NCC,LPC,CSAC
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2016
Last updated Jun 2nd, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093163065 NPPES
Wisconsin MEDICAID 100057092

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