Organization
LA CROSSE COUNSELING & WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE R. JOHNSON MS, LPC, SAC (OWNER & PSYCHOTHERAPIST)
(608) 616-1010
Entity
Organization
Contact information
Practice address
704 SAND LAKE RD STE 105, ONALASKA, WI 54650-2456
(608) 799-3881
(608) 440-2823
Mailing address
704 SAND LAKE RD STE 105, ONALASKA, WI 54650-2456
(608) 799-3881
(608) 440-2823
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15560-131
WI
101YP2500X
Professional Counselor
Primary
3067-125
WI
261QM0850X
Adult Mental Health Clinic/Center
3067-125
WI
261QM0855X
Adolescent and Children Mental Health Clinic/Center
3067-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689616518
NPPES-TYPE I NPI
—
Enumeration date
07/08/2017
Last updated
07/21/2022
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