Organization
WASHINGTON COUNTY WISCONSIN
Active
Other names
Washington County Human Services Mental Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC DIAMOND (ADMINISTRATOR)
(262) 335-4591
Entity
Organization
Contact information
Practice address
333 E. WASHINGTON STREET, SUITE 2100, WEST BEND, WI 53095-2585
(262) 335-4583
(262) 335-6827
Mailing address
333 E. WASHINGTON STREET, SUITE 2100, WEST BEND, WI 53095-2585
(262) 335-4583
(262) 335-6827
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
1968
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32976700
—
WI
05
—
41760200
—
WI
05
—
42140400
—
WI
05
—
43071300
—
WI
05
—
43107500
—
WI
05
—
43422500
—
WI
Enumeration date
07/11/2006
Last updated
08/11/2015
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