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Organization
NORTHWEST COUNSELING & GUIDANCE CLINIC
Active
Organization
NORTHWEST COUNSELING & GUIDANCE CLINIC
Active
Parent organization
NORTHWEST COUNSELING & GUIDANCE CLINIC
Other names
Northwest Journey-DePere
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHWEST COUNSELING & GUIDANCE CLINIC
Authorized official
JACKIE J MAURER (OFFICE SUPERVISOR)
(715) 349-7069
Entity
Organization
Contact information
Practice address
1119 W KENNEDY AVE, STE A, KIMBERLY, WI 54136-2213
(920) 364-9668
(888) 625-8634
Mailing address
PO BOX 309, SIREN, WI 54872-0309
(715) 349-7069
(888) 625-8634
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
2160
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42626
HEALTH PARTNERS
MN
05
—
43005000
—
WI
01
—
85575
PREFERRED ONE
MN
Enumeration date
03/23/2007
Last updated
08/15/2022
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