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464 Daly Ave #1 Wisconsin Rapids WI 54494-4746 | |
| (175) 423-2030 | |
| (715) 423-2032 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 464 Daly Ave, Wisconsin Rapids, Wisconsin |
| Authorized Official Name and Position | Deborah S Fuehrer (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Contact | 7154232030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
464 Daly Ave #1 Wisconsin Rapids WI 54494-4746 Ph: (175) 423-2030 | 464 Daly Ave #1 Wisconsin Rapids WI 54494-4746 Ph: (175) 423-2030 |
| NPI Number | 1376635094 |
|---|---|
| Provider Enumeration Date | 09/29/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376635094 | NPI | - | NPPES |
| 32040300 | Medicaid | WI | |
| 42242700 | Medicaid | WI | |
| 39771800 | Medicaid | WI | |
| 43572300 | Medicaid | WI | |
| 39131600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 2352 (Wisconsin) | Primary |
Cline Counseling And Consulting, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7151 Evergreen Ave, Wisconsin Rapids, WI 54494 Phone: 920-454-0314 | |
Central Wisconsin Counseling Associates, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 320 W Grand Ave, Suite 304a, Wisconsin Rapids, WI 54495 Phone: 715-424-6960 Fax: 715-424-6963 | |