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Organization

ASPEN FAMILY COUNSELING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BARRY D ERATH LCSW (CLINIC DIRECTOR)
(608) 742-5020
Entity
Organization

Contact information

Practice address
2639 NEW PINERY RD, SUITE 1, PORTAGE, WI 53901-1110
(608) 742-5020
(608) 742-3641
Mailing address
2639 NEW PINERY RD, SUITE 1, PORTAGE, WI 53901-1110
(608) 742-5020
(608) 742-3641

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1066
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42202000
WI
01
570028
DEAN HEALTHCARE PROVIDER
WI
01
81145030
THE ALLIANCE PROVIDER #
WI
Enumeration date
05/02/2006
Last updated
07/21/2022
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