Organization
RISING HOPE FAMILY COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE MARIE VANDER WIELEN (OWNER)
(920) 915-7198
Entity
Organization
Contact information
Practice address
1486 KENWOOD DR, MENASHA, WI 54952-1133
(920) 739-2100
Mailing address
1486 KENWOOD DR, MENASHA, WI 54952-1133
(920) 915-7198
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7710-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7710-123
STATE OF WISCONSIN
WI
Enumeration date
04/03/2012
Last updated
12/12/2022
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