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Organization
KETTLE MORAINE COUNSELING LLC
Active
Organization
KETTLE MORAINE COUNSELING LLC
Active
Other names
Kettle Moraine Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
DEVONA LYNN MARSHALL MS LPC NCC (OWNER/DIRECTOR)
(262) 334-4340
Entity
Organization
Contact information
Practice address
400 W RIVER DR, WEST BEND, WI 53090-1567
(262) 334-4340
(262) 334-4341
Mailing address
400 W RIVER DR, WEST BEND, WI 53090-1567
(262) 334-4340
(262) 334-4341
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
3514-125
WI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/24/2009
Last updated
01/14/2020
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