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Organization

MERAKI THERAPY & WELLNESS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE WAACK MAC, LPC, CSAC (CO-OWNER)
(920) 288-2846
Entity
Organization

Contact information

Practice address
1270 MAIN ST STE 120, GREEN BAY, WI 54302-1337
(920) 378-3575
Mailing address
1270 MAIN ST STE 120, GREEN BAY, WI 54302-1337
(920) 288-2846
(920) 770-4153

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100095134
WI
05
1336784545
WI
Enumeration date
05/18/2022
Last updated
11/13/2022
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