Evolve Counseling Llc | |
2600 Rib Mountain Dr Suite 101 Wausau WI 54401-7196 | |
(715) 298-6201 | |
(715) 600-9031 |
Full Name | Evolve Counseling Llc |
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Speciality | Counselor |
Location | 2600 Rib Mountain Dr, Wausau, Wisconsin |
Authorized Official Name and Position | Janice J Spangler (OWNER) |
Authorized Official Contact | 7152986201 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Evolve Counseling Llc 2600 Rib Mountain Dr Suite 101 Wausau WI 54401-7196 Ph: (715) 298-6201 | Evolve Counseling Llc 2600 Rib Mountain Dr Suite 101 Wausau WI 54401-7196 Ph: (715) 298-6201 |
NPI Number | 1699120816 |
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Provider Enumeration Date | 04/25/2016 |
Last Update Date | 04/25/2016 |
Medicare PECOS PAC ID | 6002267598 |
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Medicare Enrollment ID | O20240109003140 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699120816 | NPI | - | NPPES |
100039690 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 5581125 (Wisconsin) | Primary |
Provider Name | Janice Jean Spangler |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1295000610 PECOS PAC ID: 8729439211 Enrollment ID: I20240109003286 |
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