Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Fastback Physical Therapy LLC

Organization Mental Health Counselor · NPI 1104393982

Fastback Physical Therapy LLC is a Mental Health Counselor in New Berlin, Wisconsin. Registered with an NPI since 2018.

In the registry since
2018
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3333 S Sunnyslope Rd Ste 103B
New Berlin, WI 53151-4504
Phone: (262) 853-8452
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1104393982
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michele Weninger — Credentialing Specialist · (248) 601-9207
NPI enumeratedOctober 30, 2018
Last updated in NPPESAugust 6, 2024
Certification dateAugust 6, 2024
Mailing address1773 Star Batt Dr, Rochester Hills, MI 48309-3708

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