| Center For Human Development | |
|
631 Forest St Wausau WI 54403-5524 | |
| (715) 842-0944 | |
| (715) 845-6477 |
| Full Name | Center For Human Development |
|---|---|
| Speciality | Counselor |
| Location | 631 Forest St, Wausau, Wisconsin |
| Authorized Official Name and Position | Edmund Lee Webster (DIRECTOR) |
| Authorized Official Contact | 7158420944 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Human Development 631 Forest St Wausau WI 54403-5524 Ph: (715) 842-0944 | Center For Human Development 631 Forest St Wausau WI 54403-5524 Ph: (715) 842-0944 |
| NPI Number | 1679684609 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 09/02/2014 |
| Medicare PECOS PAC ID | 0345394037 |
|---|---|
| Medicare Enrollment ID | O20090814000206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679684609 | NPI | - | NPPES |
| 42135100 | Medicaid | WI | |
| 62743 | Other | WI | MULTIPLAN/WPPN |
| DA2153 | Other | RAILROAD MEDICARE | |
| 305912 | Other | MHN | |
| 1008111 | Other | CIGNA BEHAVIORAL HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 1153 (Wisconsin) | Primary |
| Provider Name | Edmond L Webster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376576231 PECOS PAC ID: 7012061708 Enrollment ID: I20090814000167 |
| Provider Name | Krista Kocha |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790279305 PECOS PAC ID: 9638518392 Enrollment ID: I20240415003502 |
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