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Organization
COUNSELING & DEVELOPMENT CENTER
Active
Organization
COUNSELING & DEVELOPMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIE SEIDL (FINANCIAL MANAGER)
(715) 339-3048
Entity
Organization
Contact information
Practice address
171 CHESTNUT ST, PHILLIPS, WI 54555-1313
(715) 339-3048
(715) 339-2436
Mailing address
171 CHESTNUT ST, PO BOX 71, PHILLIPS, WI 54555-1313
(715) 339-3048
(715) 339-2436
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1244
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3931356642010
BLUE CROSS BLUE SHIEL
WI
05
—
42141300
—
WI
Enumeration date
02/13/2007
Last updated
12/11/2009
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