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Organization

NORTHSIDE MENTAL HEALTH AND CONSULTING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHRISTOPHER JAY WIRTH MS (OWNER/PSYCHOTHERAPIST)
(608) 577-4555
Entity
Organization

Contact information

Practice address
1310 MENDOTA ST, SUITE 114, MADISON, WI 53714-1039
(608) 577-4555
Mailing address
1310 MENDOTA ST, SUITE 114, MADISON, WI 53714-1039
(608) 577-4555

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
183-228
WI

Other

Enumeration date
06/08/2011
Last updated
06/08/2011
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