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Organization

GROWING OAK LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LINDSAY LOEWE LPC (MENTAL HEALTH & SUBSTANCE ABUSE)
(608) 469-1753
Entity
Organization

Contact information

Practice address
112 WATSON ST, RIPON, WI 54971-1327
(920) 896-0189
(920) 694-3021
Mailing address
112 WATSON ST, RIPON, WI 54971-1327
(920) 896-0189
(920) 694-3021

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4622-125
WI
101YP2500X
Professional Counselor
Primary
4622-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1235417593
INDIVIDUAL NPI NUMBER
Enumeration date
09/06/2012
Last updated
09/06/2012
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