Individual provider · Type 1 NPI

Benjamin Sidesky

Addiction (Substance Use Disorder) Counselor · Waukesha, WI

NPI number 1194699124 Active

Practice location

2422 N Grandview Blvd
Waukesha, WI 53188-6105

Call (262) 549-6600 Map

Fax (262) 549-6698

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X20522-130 (WI)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1194699124

Benjamin Sidesky's National Provider Identifier is 1194699124, issued on Oct 2, 2025. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Waukesha, WI. The record was last updated on Oct 2, 2025.