Individual
CASSIDY MICHAEL SALM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, SAC-IT
Contact information
Practice address
4340 ELM LAWN RD, OCONTO FALLS, WI 54154-9656
(920) 944-9373
Mailing address
2420 SYCAMORE DR # B32, GREEN BAY, WI 54311-5396
(920) 286-2046
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
19535-130
WI
101YP2500X
Professional Counselor
Primary
10869-125
WI
Other
Enumeration date
03/12/2022
Last updated
03/12/2024
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