Organization
IMPACT COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RENEE MARIE MILLWOOD MS, LCSW (DIRECTOR)
(715) 634-0607
Entity
Organization
Contact information
Practice address
15655 COUNTY ROAD B, HAYWARD, WI 54843-3251
(715) 634-0607
(715) 634-0617
Mailing address
15655 COUNTY HWY B, P.O. BOX 13251, HAYWARD, WI 54843
(715) 634-0607
(715) 634-0617
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
42213900
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42213900
—
WI
Enumeration date
02/27/2008
Last updated
08/11/2008
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