Organization
PASSAGEWAY, INC. FRS-TR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN M MILLER LPC CSAC ICS (PRESIDENT/ PROVIDER)
(608) 563-5633
Entity
Organization
Contact information
Practice address
3246 W ROLLINGWOOD DR, JANESVILLE, WI 53545-9030
(608) 563-5633
(608) 563-4122
Mailing address
3246 W ROLLINGWOOD DR, JANESVILLE, WI 53545-9030
(608) 563-5633
(608) 563-4122
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15139-132
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
15375-135
WI
101YP2500X
Professional Counselor
Primary
2864-125
WI
Other
Enumeration date
10/25/2010
Last updated
01/25/2017
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