Organization
SYNERGY COUNSELING SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NEIL C. VANROSSUM MS (DIRECTOR)
(715) 526-5466
Entity
Organization
Contact information
Practice address
1415 EAST GREEN BAY ST., SUITE 191, SHAWANO, WI 54166-3881
(715) 526-5466
(715) 526-5545
Mailing address
1415 EAST GREEN BAY ST., SUITE 191, SHAWANO, WI 54166-3881
(715) 526-5466
(715) 526-5545
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
1894
WI
101Y00000X
Counselor
1895
WI
101Y00000X
Counselor
1896
WI
103T00000X
Psychologist
1802057
WI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42175300
—
WI
05
—
42196300
—
WI
05
—
42196400
—
WI
05
—
42225900
—
WI
Enumeration date
08/03/2006
Last updated
09/01/2009
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