Organization
IM FINE COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD L REYNOLDS LPC CSAC (PSYCHOTHERAPIST/ OWNER)
(920) 728-1810
Entity
Organization
Contact information
Practice address
20 SHERMAN AVE E, FORT ATKINSON, WI 53538-1864
(920) 728-1810
Mailing address
20 SHERMAN AVE E, FORT ATKINSON, WI 53538-1864
(920) 728-1810
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
03/03/2020
Last updated
03/23/2021
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