| Central Wisconsin Counseling Associates, Llc | |
|
320 W Grand Ave Suite 304a Wisconsin Rapids WI 54495-2781 | |
| (715) 424-6960 | |
| (715) 424-6963 |
| Full Name | Central Wisconsin Counseling Associates, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 320 W Grand Ave, Wisconsin Rapids, Wisconsin |
| Authorized Official Name and Position | Ann Auril Soe (OWNER) |
| Authorized Official Contact | 7154246960 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Central Wisconsin Counseling Associates, Llc 320 W Grand Ave Suite 304a Wisconsin Rapids WI 54495-2781 Ph: (715) 424-6960 | Central Wisconsin Counseling Associates, Llc 320 W Grand Ave Suite 304a Wisconsin Rapids WI 54495-2781 Ph: (715) 424-6960 |
| NPI Number | 1316012396 |
|---|---|
| Provider Enumeration Date | 11/22/2006 |
| Last Update Date | 05/05/2021 |
| Certification Date | 05/05/2021 |
| Medicare PECOS PAC ID | 7416016209 |
|---|---|
| Medicare Enrollment ID | O20081107000766 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316012396 | NPI | - | NPPES |
| 42224800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Roger D Pagel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609942903 PECOS PAC ID: 6406912070 Enrollment ID: I20230202002966 |
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