Organization
PHOENIX COUNSELING, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID A KUYKENDALL MSW (DIRECTOR)
(608) 825-6711
Entity
Organization
Contact information
Practice address
1500 WEST MAIN STREET, SUITE 300, SUN PRAIRIE, WI 53590
(608) 825-6711
(608) 834-6499
Mailing address
1500 WEST MAIN ST. SUITE 300, SUN PRAIRIE, WI 53590
(608) 825-6711
(608) 834-6499
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
621
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42226100
—
WI
Enumeration date
03/16/2007
Last updated
09/04/2007
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