Individual
MR. RICHARD L ROUSE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
300 CROOKS STREET, GREEN BAY, WI 54301
(920) 436-6800
(920) 437-3540
Mailing address
PO BOX 22308, 300 CROOKS STREET, GREEN BAY, WI 54305-2308
(920) 436-6800
(920) 437-3540
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0080251
NM
101YM0800X
Mental Health Counselor
178003890
IL
101YP2500X
Professional Counselor
Primary
3977-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43732700
—
WI
Enumeration date
10/31/2006
Last updated
06/04/2009
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