Organization
WATERTOWN PHYSICIAN PRACTICES LLC
Active
Other names
WRMC Directions Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNETTA TRAYLOR (AO)
(502) 596-6063
Entity
Organization
Contact information
Practice address
129 HOSPITAL DR, WATERTOWN, WI 53098-3334
(920) 252-4800
(920) 262-4813
Mailing address
680 S 4TH ST, LOUISVILLE, KY 40202-2407
(502) 596-6063
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
07/18/2015
Last updated
06/26/2025
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