Organization
NORTHWEST COUNSELING & GUIDANCE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE J MAURER (OFFICE SUPERVISOR)
(715) 349-7069
Entity
Organization
Contact information
Practice address
2916 BORHAM AVE, STE A, STEVENS POINT, WI 54481-5099
(715) 997-9486
(888) 625-8634
Mailing address
PO BOX 309, SIREN, WI 54872-0309
(715) 349-7069
(888) 625-8634
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
2404
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42626
HEALTH PARTNERS
MN
05
—
43007300
—
WI
01
—
7H956NO
BCBS OF MN
WI
01
—
85575
PREFERRED ONE
MN
Enumeration date
03/27/2007
Last updated
08/19/2022
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