Organization
QUEST COUNSELING AND CONSULTATION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA DERKS LPC (OWNER/PSYCHOTHERAPIST)
(847) 708-4192
Entity
Organization
Contact information
Practice address
740 REGENT ST STE 103, MADISON, WI 53715-2648
(847) 708-4192
Mailing address
740 REGENT ST STE 103, MADISON, WI 53715-2648
(847) 708-4192
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5616-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YP2500X
—
WI
Enumeration date
06/01/2018
Last updated
06/01/2018
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