# NORTHWEST COUNSELING & GUIDANCE CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NORTHWEST COUNSELING & GUIDANCE CLINIC
- **Other names:** Northwest Journey - Northern Lights
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790143667
- **Legal business name:** NORTHWEST COUNSELING & GUIDANCE CLINIC
- **Authorized official:** JACKIE MAURER (OFFICE SUPERVISOR)
- **Authorized official phone:** (715) 349-7069

## Contact information

- **Practice address:** 69 N 28TH ST E, SUPERIOR, WI 54880-6525
- **Practice address phone:** (715) 718-2777
- **Practice address fax:** (715) 394-2869
- **Mailing address:** PO BOX 309, SIREN, WI 54872-0309
- **Mailing address phone:** (715) 349-7069
- **Mailing address fax:** (715) 327-8509

## Taxonomy

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

## Other

- **Enumeration date:** 02/05/2016
- **Last updated:** 03/21/2024