| Anchor Bay Counseling Center Llc | |
|
329 S River St # 301 Spooner WI 54801-9726 | |
| (715) 939-1393 | |
| (715) 939-1394 |
| Full Name | Anchor Bay Counseling Center Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 329 S River St # 301, Spooner, Wisconsin |
| Authorized Official Name and Position | Darren Douglas Cox (OWNER) |
| Authorized Official Contact | 7159391393 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anchor Bay Counseling Center Llc Po Box 574 Spooner WI 54801-0574 Ph: (715) 939-1393 | Anchor Bay Counseling Center Llc 329 S River St # 301 Spooner WI 54801-9726 Ph: (715) 939-1393 |
| NPI Number | 1386189363 |
|---|---|
| Provider Enumeration Date | 12/29/2016 |
| Last Update Date | 12/29/2016 |
| Medicare PECOS PAC ID | 8123392479 |
|---|---|
| Medicare Enrollment ID | O20170925003457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386189363 | NPI | - | NPPES |
| 40980600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 3433-125 (Wisconsin) | Primary |
| Provider Name | Anne M Focht |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780904284 PECOS PAC ID: 7810184595 Enrollment ID: I20101207000663 |
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