Organization
GARSON GROWTH & COUNSELING SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY C GARSON MSSW, LCSW (DIRECTOR)
(715) 284-0361
Entity
Organization
Contact information
Practice address
54 N 1ST ST, BLACK RIVER FALLS, WI 54615-1311
(715) 284-0361
(715) 333-5007
Mailing address
54 N 1ST ST, PO BOX 387, BLACK RIVER FALLS, WI 54615
(715) 284-0361
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2260
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42219200
—
WI
01
—
44525
MEDICARE PART B
WI
Enumeration date
10/03/2007
Last updated
10/03/2007
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