# NORTHWEST COUNSELING & GUIDANCE CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northwest Journey-Green Bay
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295224657
- **Authorized official:** JACKIE MAURER (OFFICE SUPERVISOR)
- **Authorized official phone:** (715) 349-7069

## Contact information

- **Practice address:** 123 S VAN BUREN, GREEN BAY, WI 54301-4441
- **Practice address phone:** (920) 336-8960
- **Mailing address:** PO BOX 309, SIREN, WI 54872-0309
- **Mailing address phone:** (715) 349-5801
- **Mailing address fax:** (888) 625-8634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | 3197 | WI | Yes |

## Other

- **Enumeration date:** 05/01/2018
- **Last updated:** 05/01/2018