| Blackstone Therapy, Llc | |
|
2940 Chapel Valley Rd Ste 2 Fitchburg WI 53711-6451 | |
| (608) 501-3600 | |
| (608) 621-5162 |
| Full Name | Blackstone Therapy, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2940 Chapel Valley Rd Ste 2, Fitchburg, Wisconsin |
| Authorized Official Name and Position | Guy Blackstone (VICE PRESIDENT) |
| Authorized Official Contact | 6085040641 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blackstone Therapy, Llc 2940 Chapel Valley Rd Ste 2 Fitchburg WI 53711-6451 Ph: (608) 504-0641 | Blackstone Therapy, Llc 2940 Chapel Valley Rd Ste 2 Fitchburg WI 53711-6451 Ph: (608) 501-3600 |
| NPI Number | 1205562030 |
|---|---|
| Provider Enumeration Date | 07/25/2022 |
| Last Update Date | 03/27/2024 |
| Certification Date | 03/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205562030 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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