# IMPACT COUNSELING SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467626606
- **Authorized official:** RENEE M MILLWOOD MS, LCSW (DIRECTOR)
- **Authorized official phone:** (715) 634-0607

## Contact information

- **Practice address:** 301 ELLIS AVE, SUITE 1, ASHLAND, WI 54806-1667
- **Practice address phone:** (715) 682-3523
- **Mailing address:** 15655 CO HWY B, PO BOX 13251, HAYWARD, WI 54843
- **Mailing address phone:** (715) 634-0607

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | 43008600 | WI | Yes |

## Other

- **Enumeration date:** 04/18/2008
- **Last updated:** 08/11/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 43008600 | — | WI |