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Organization
NORTHWEST COUNSELING & GUIDANCE CLINIC
Active
Organization
NORTHWEST COUNSELING & GUIDANCE CLINIC
Active
Parent organization
NORTHWEST COUNSELING AND GUIDANCE CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHWEST COUNSELING AND GUIDANCE CLINIC
Authorized official
JACKIE J MAURER (BILLING OFFICE SUPERVISOR)
(715) 327-4322
Entity
Organization
Contact information
Practice address
5655 N. 28TH AVE, WAUSAU, WI 54401-9709
(715) 675-5454
(715) 675-0545
Mailing address
203 UNITED WAY, FREDERIC, WI 54837-8938
(715) 327-4322
(715) 327-8509
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
2404
WI
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42626
HEALTH PARTNERS
MN
05
—
4300700
—
WI
05
—
43007000
—
WI
01
—
85575
PREFERRED ONE
MN
Enumeration date
03/23/2007
Last updated
11/23/2015
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