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Organization
COUCH COUNSELING CENTER, LLC
Active
Organization
COUCH COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DERREKA J WALTON LPC (OWNER/PROFESSIONAL COUNSELOR)
(920) 872-7292
Entity
Organization
Contact information
Practice address
806 VALLEY RD STE 13, MENASHA, WI 54952-1012
(920) 872-7292
(920) 872-7066
Mailing address
806 VALLEY RD STE 13, MENASHA, WI 54952-1012
(920) 872-7292
(920) 872-7066
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104418318
PRIVATE INSURANCE
WI
05
—
1104418318
—
WI
Enumeration date
07/21/2021
Last updated
07/21/2021
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